Hypothermia and Frostbite

Authors: Dean Burns, Duncan J McAuley / Editor: Adrian Boyle / Reviewer: Lakshay Chanana, Rebecca Ford / Code: A6, R1 / Published: 13/12/2022

This module covers the assessment, treatment and management of patients presenting to an emergency department (ED) with the effects of hypothermia and frostbite.

By the end of this session you will be able to:

  • Discuss the pathophysiology of hypothermia
  • Describe the physiological changes that occur with falling core temperature
  • Select the correct method of rewarming based on the severity of the hypothermia and the other clinical circumstances
  • Describe the management of frostbite
START MODULE

References

  1. Currier J. Hypothermia. In: Harwood-Nuss A, Wolfson AB, Linden CH et al, eds. The Clinical Practice of Emergency Medicine. 3rd edn. Philadelphia: Lippincott Williams & Wilkins; 2001: 1664-1667.
  2. Hanania NA, Zimmerman JL. Accidental hypothermia. Crit Care Clin. 1999 Apr;15(2):235-49. doi: 10.1016/s0749-0704(05)70052-x.
  3. Biem J, Koehncke N, Classen D, et al. Out of the cold: management of hypothermia and frostbite. CMAJ 2003;168:305-311.
  4. Papenhausen M, Burke L, Antony A, Phillips JD. Severe hypothermia with cardiac arrest: complete neurologic recovery in a 4-year-old child. J Pediatr Surg. 2001 Oct;36(10):1590-2.
  5. ECC Committee, Subcommittees and Task Forces of the American Heart Association. 2005 American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care. Circulation. 2005 Dec 13;112(24 Suppl):IV1-203.
  6. Kroeger K, Janssen S, Niebel W. Frostbite in a mountaineer. Vasa. 2004 Aug;33(3):173-6.
  7. Kpper T, Steffgen J, Jansing P. Cold exposure during helicopter rescue operations in the Western Alps. Ann Occup Hyg 2003;47:7-16.
  8. Petrone P, Kuncir EJ, Asensio JA. Surgical management and strategies in the treatment of hypothermia and cold injury. Emerg Med Clin North Am. 2003 Nov;21(4):1165-78.
  9. Ervasti O, Juopperi K, Kettunen P, Remes J, et al. The occurrence of frostbite and its risk factors in young men. Int J Circumpolar Health. 2004 Mar;63(1):71-80.
  10. Reamy BV. Frostbite: review and current concepts. J Am Board Fam Pract. 1998 Jan-Feb;11(1):34-40.
  11. Murphy JV, Banwell PE, Roberts AH, McGrouther DA. Frostbite: pathogenesis and treatment. J Trauma. 2000 Jan;48(1):171-8.
  12. Cauchy E, Marsigny B, Allamel G, et al. The value of technetium 99 scintigraphy in the prognosis of amputation in severe frostbite injuries of the extremities: A retrospective study of 92 severe frostbite injuries. J Hand Surg Am. 2000 Sep;25(5):969-78.
  13. Bhatnagar A, Sarker BB, Sawroop K, et al. Diagnosis, characterisation and evaluation of treatment response of frostbite using pertechnetate scintigraphy: a prospective study. Eur J Nucl Med Mol Imaging. 2002 Feb;29(2):170-5.
  14. Su CW, Lohman R, Gottlieb LJ. Frostbite of the upper extremity. Hand Clin. 2000 May;16(2):235-47.

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