Common Childhood Injuries and Poisonings

Frostbite

What is frostbite?

Frostbite is damage to the skin from freezing and is due to prolonged exposure to cold temperatures, usually below 32° F. It occurs when ice crystals form in the skin or deeper tissue. The most common sites for frostbite are the fingers, hands, toes, feet, ears, nose, and cheeks. The severity depends on several factors including temperature, length of exposure, wind-chill factor, dampness, and type of clothing worn. Children are more prone to frostbite than adults because they lose heat from their skin faster and do not want to come inside when having fun playing outdoors.

What is frostnip?

Frostnip is less severe and affects the tips of the cheeks, ears, nose, fingers, and toes. It can usually be treated at home. The skin may be reddened and feel numb or tingly. If this occurs, bring your child inside and warm the skin by using warm compresses or immersing the area in warm water (100º F to 105º F) until sensation returns. Do not rub or massage the skin. If symptoms of frostbite occur or warming the skin does not help, call your child's physician immediately.

What are the symptoms of frostbite?

The following are some of the most common symptoms of frostbite. However, each child may experience symptoms differently. Symptoms may include:

• skin is reddened and then becomes white, hard, and swollen
• skin burns, tingles or becomes numb

Severe frostbite can result in blisters or ulcers forming and may involve deeper tissues. As frostbite progresses, tissue death and gangrene may occur. The symptoms of frostbite may resemble other conditions and medical problems. Always consult your child's physician for a diagnosis.

First-aid for frostbite:

Specific treatment for frostbite will be determined by your child's physician based on the extent and severity of the injury. In general:

• Remain calm and reassure your child that you can help. If feet are affected, carry your child; do not allow him/her to walk.
  
  
• Move your child inside to a warm area and put him/her in dry clothes. Call your child's physician or take your child to the emergency room immediately. Frostbite can cause serious injury and needs immediate medical attention.
  
  
• While waiting for medical assistance:
  
  
  • Give your child something warm to drink and wrap a blanket around him/her.
    
    
  • Warm the skin by using warm compresses or immersing the area in warm water (100º F to 105º F) until sensation returns.
    
    
  • Do not rub or massage the skin.
    
    
  • Do not use direct heat such as heating pads or fires.
    
    
  • Do not place the frostbitten skin in snow to "warm" it.
    
    
  • Apply clean cotton or gauze between fingers and toes if they are affected.
    
    
  • Do not disturb any blisters.
    
    
  • Wrap warmed areas of the skin to prevent further damage.

Further treatment will depend on the extent and severity of injury and may include treatment of skin damage with debridement or surgery.

Prevention of frostbite:

To help prevent frostbite, consider the following:

• Dress your child warmly in layers. Make sure ears, fingers, and toes are well covered.
  
  
• Change clothing if it becomes wet, especially socks and mittens.
  
  
• Bring your child indoors often to warm up and provide a warm snack, soup, or drink.
  
  
• Be alert for early signs of frostnip and frostbite and teach your child what signs to watch for.