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- Cold injury (or cold weather injury) is damage to the body from cold exposure, including hypothermia and several skin injuries. Cold-related skin injuries are categorized into freezing and nonfreezing cold injuries. Freezing cold injuries involve tissue damage when exposed to temperatures below freezing (less than 0 degrees Celsius). Nonfreezing cold injuries involve tissue damage when exposed to temperatures often between 0-15 degrees Celsius for extended periods of time. While these injuries have disproportionally affected military members, recreational winter activities have also increased the risk and incidence within civilian populations. Additional risk factors include homelessness, inadequate or wet clothing, alcohol abuse or tobacco abuse, and pre-existing medical conditions that impair blood flow. Freezing cold skin injuries include frostbite and frostnip. These injuries often affect the fingers, toes, nose, and ears since they are less commonly covered by clothing when in cold environments. Affected skin becomes numb, turns white or blue, and develops blisters. Frostnip is a superficial skin injury that won't freeze the skin or cause long-term damage. Frostbite involves freezing of fluids inside and outside of cells that results in cell breakdown, electrolyte imbalances, and inflammation. Surrounding blood vessel constriction and injury disrupts blood flow to affected tissue, which may cause tissue death (necrosis). Diagnosis is based on symptoms, but imaging can help assess viable tissue and risk of amputation. Pre-hospital treatment involves transfer to a warm environment, changing wet clothing, and rapid rewarming with warm water if refreezing is not expected. Hospital management involves rewarming, wound care, and medications to treat pain and possible blood clots. Amputation of unsalvageable tissue may be required weeks to months after initial injury. Nonfreezing cold skin injuries include trench foot, a subclass of immersion foot caused by exposure to cold temperatures. These injuries often affect the feet after being subjected to wet cold for several hours or days. Affected individuals report a tingling or numbing sensation, red or blue discoloration, and swelling or blisters in affected skin. The mechanism of injury isn't fully understood, but may involve cold-induced damage to blood vessels and nerves that results in small blood vessel (capillary) destruction, swelling, and tissue necrosis. Diagnosis is based on symptoms. Pre-hospital treatment includes transfer to a warm environment and exchanging wet clothing. Hospital management includes gradual rewarming with air drying, elevating affected skin, and pain management. (en)
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- Frostbitten fingers after descent from mountain climbing (en)
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| dbp:causes
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- Exposure to cold temperatures (en)
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| dbp:complications
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- Necrosis, gangrene, chronic pain, amputation (en)
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| dbp:diagnosis
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| dbp:differential
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- Hypothermia, Raynaud's phenomenon, chilblains , cold urticaria (en)
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| dbp:name
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| dbp:prevention
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- Minimize cold exposure, wear protective clothing, change wet clothing, avoid substance use, maintain appropriate nutrition (en)
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| dbp:risks
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- Military occupation, recreational winter activities, homelessness, inadequate or wet clothing, substance abuse, diabetes, peripheral vascular disease (en)
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| dbp:symptoms
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- Numbness, skin discoloration, blisters, swelling, cold sensation (en)
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| dbp:treatment
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- Move to warm and dry environment, rewarming, medication, wound care, surgery (en)
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| dbp:types
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- Freezing, nonfreezing (en)
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- Cold injury (or cold weather injury) is damage to the body from cold exposure, including hypothermia and several skin injuries. Cold-related skin injuries are categorized into freezing and nonfreezing cold injuries. Freezing cold injuries involve tissue damage when exposed to temperatures below freezing (less than 0 degrees Celsius). Nonfreezing cold injuries involve tissue damage when exposed to temperatures often between 0-15 degrees Celsius for extended periods of time. While these injuries have disproportionally affected military members, recreational winter activities have also increased the risk and incidence within civilian populations. Additional risk factors include homelessness, inadequate or wet clothing, alcohol abuse or tobacco abuse, and pre-existing medical conditions that i (en)
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