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Medical Author:

Melissa Conrad Stöppler, MD, Chief Medical Editor

Melissa Conrad Stöppler, MD, Chief Medical Editor

Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.

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Medical Editor:

Mary Nettleman, MD, MS, MACP

Mary Nettleman, MD, MS, MACP

Mary D. Nettleman, MD, MS, MACP is the Chair of the Department of Medicine at Michigan State University. She is a graduate of Vanderbilt Medical School, and completed her residency in Internal Medicine and a fellowship in Infectious Diseases at Indiana University.

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After initial life threats are excluded, rewarming is the highest priority.

• This is accomplished rapidly in a water bath heated to 40-42 C (104-107.6 F) and continued until the thaw is complete (usually 15 to 30 minutes).
  
  
• Narcotic pain medications may be given because this process is very painful.
  
  
• Because dehydration is very common, IV fluids may also be given.

After rewarming, post-thaw care is undertaken in order to prevent infection and a continuing lack of oxygen to the area.

• The clear blisters are debrided (dead tissue is removed) while the bloody ones are often left intact so as not to disturb the underlying blood vessels.
  
  
• When there is a great risk of damage enough to require amputation (for example, multiple digits, or proximal amputation), tPA (tissue plasminogen activator) may be given into an artery to reduce the incidence of blood clots. This can only be given to people who are not at risk for significant bleeding complications.
  
  
• A tetanus booster is given if needed.

People with frostbite are hospitalized for at least 1 to 2 days to determine the extent of injury and to receive further treatment.

• Aloe vera cream is applied every 6 hours, and the area is elevated and splinted.
  
  
• Ibuprofen or similar agents may be given to combat inflammation.
  
  
• For deep frostbite, daily water therapy in a 40 C (104 F) whirlpool bath will be performed in order to remove any dead tissue.

A number of experimental therapies do exist, many of which aim to further treat the inflammation or decreased blood flow seen in frostbite. As of yet, none of these treatments has proven beneficial.

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