Introduction
Frostbite is a form of skin damage that comes as a result of prolonged exposure to the cold and/or extreme cold winds. Frostbite generally occurs in the extremities with the hands and feet accounting for 90% of frostbite injuries and the nose, cheeks, ears and lips accounting for the other 10% [8]. Frostbite initiates once the skin reaches 0oC [4] so those in sub 0 environments are most at risk. Susceptibility to frostbite increases in people without optimal circulation such as those with diabetes, autoimmune vascular disorders or atherosclerosis obliterans [6]. The elderly and very young are also at greater risk of frostbite because their bodies do not regulate temperature as effectively and have higher surface area–to-body–mass
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ratios [7]. Signs and Symptoms Symptoms of frostbite include; cold, hard or white skin, pain, loss of feeling, itching, swelling and blistering, mottled skin, tissue loss (depending on severity) or the area of skin becoming blotchy and red when warmed [2]. Typically the severity of the frostbite can be determined by the blisters that have been formed, if the blisters are clear, recovery is likely however, if the blisters are filled with blood this could be indicative of deeper tissue damage. Two types of gangrene can occur as a result of frostbite; dry gangrene where the skin turns hard and black and wet gangrene where the skin appears soft and grey, either of these can result in the skin falling off or will require surgery to be removed [1]. If any of these symptoms occur after being exposed to extreme cold, the skin area should be shown to a medical professional for examination. Immediate first aid includes; reduction of exposure to wind and/or cold, removing any wet clothing, no smoking (as nicotine constricts blood vessels) and to not rub the affected area. Ensuring the affected person stays warm is very important however, like the extreme cold, extreme and/or radiating heat can also run the risk of further damaging the tissue. Submerging the damaged skin in warm water is the best option for rewarming but it is very important not to thaw out the skin if there is likelihood that it could be refrozen [1]. Classifications Frostbite can be put under 4 degrees of severity; first degree- white plaque surrounded by hyperaemia, epidermal involvement, erythema and mild oedema. Second degree – full-thickness skin freezing, clear blister formation surrounded by erythema, harder outer skin but resilient tissue underneath. Third degree – sub dermal plexus freezing, haemorrhagic blisters, skin appears a blue-grey colour, pain on rewarming that can last 5 weeks and thick, gangrenous scab formation within two weeks and fourth degree – the damage of muscle bone and tendons, little pain experienced on rewarming, minimal edema after thawing, frozen, hard and avascular skin and tissue with mottled tissue becoming dry, black and mummified [4]. These four classifications are most commonly grouped into two categories; deep and superficial. Superficial frostbite encompasses first degree and second degrees and is categorised by burning, itching, tingling and numbness in the affected areas, the skin appears white and frozen (as can be seen on figure 1), if pressed on, the skin will have some resistance. Deep frostbite contains third and fourth degrees, which are categorized by decrease in sensation that will become lost, swelling, blood filled blisters, white or yellowish hard skin that is waxy in appearance, skin has no resistance when pressed on and the patient experiences pain in the area upon thawing which starts throbbing 2-3 days until tissue separation occurs [2]. Frostbite Diagram A condition that is considered a precursor to frostbite is frostnip, this occurs under the same conditions as frostbite but is not as severe. Frostnip won’t cause any permanent damage to the skin. Symptoms of frostnip are pale and itchy skin, as shown in figure 1 it only has an effect on the very top layer of skin, not quite reaching the epidermis. Simply rewarming the affected area can treat Frostnip and the skin will return to normal [5]. Causes The freezing of skin cells causes frostbite during exposure to extremely cold environments in which the skin temperature drops below 0oC. In situations where the body goes under alert due to a severe loss of heat the hypothalamus (the part of the brain that governs heat regulation), will be sent stimuli from peripheral receptors through the spinal cord initiating responses in order to conserve heat [10]. In conditions such as these the body will preserve energy by decreasing regular shivers as they can increase your basal metabolic rate to up to 5 times faster [10]. Instead will opt for the body to constrict its blood vessels to conserve heat in the centre of the body [9]. Extreme colds causes a response within the body that constricts the blood vessels in the arms and legs; it does this in order to slow down the blood flow to the skin so it can better circulate around vital organs keeping them warm.
The body can inhibit this blood flow to only 0.5-1.0 cc/min/100 cc in full constriction, which in comparison to the normal 80-90 cc/min/100 cc during full dilation is a major decline [9]. The decrease in blood flow causes the extremities to become colder and colder which induces a condition called Hunter’s Response, this causes the blood vessels to switch between dilating for a period of time and then constricting. The body does this so that it can preserve as much function in the extremities as possible whilst still maintaining a healthy temperature in the centre of the body. However, the brain senses this as the body undergoing hyperthermia and then constricts blood vessels permanently to insure cold blood isn’t being returned to internal organs [2]. When the body restricts blood flow to the extremities they’re no longer receiving the warmth that regular blood flow provides, this causes the tissue to drop below 0oC. Skin that becomes this cold undergoes four phases resulting in frostbite. First to occur is the pre-freeze phase where the cold results in the blood becoming more viscous, blood vessels constrict and causes leakage of endothelial plasma. Secondly the freeze phase, this is when ice crystals form in the extracellular spaces of the …show more content…
skin. Third the vascular stasis phase where an arteriovenous shunt (abnormal connection between an artery and a vein) occurs between injured and normal skin, this can then cause stasis, coagulation and can form a thrombus. Lastly is the late progressive ischemia phase that consists of inflammation due to thrombus formation, hypoxia and anaerobic metabolism, which can cause tissue necrosis [4]. Treatment Immediate treatments include; warming of extremities in water 37-40oC and should only be increased 10oC every hour to avoid further damage to the affected area [9], antibiotic lotions, tetanus shots (as those with frostbite are more prone to bacterial wound infections [7]), rehydration of the patient and oral or intravenous drugs for improved circulation [1]. The person should then be checked for hypothermia right away, as this is a serious condition that occurs when the central body temperature drops below 35oC if the individual has hypothermia they must receive immediate emergency medical attention. Symptoms of hypothermia include; constant shivering, lack of energy, disorientation, cold or pale skin and hyperventilation [6]. Once the patient has seen a doctor they will undergo a number of tests in order to assess how severe the frostbite is, this would be conducted through the use of x-ray, bone scans and magnetic resonance imaging (MRI) which also help detect if there is any damage to muscle and bone [3].
Tests for assessment of blood circulation will also be administered [1]. For any tissue areas that have been damaged beyond repair the doctor will wait 1-3 months before undergoing debridement surgery to remove the dead skin, this is because the body needs that time for the region to blacken in order for the surgeon to get an idea of how extensive the damage is and work out how much needs to be removed [4]. Debridement surgery removes all dead tissues in an affected area, this is the most common form of surgery when it comes to frostbite however, in some cases amputation may be required [7]. Despite the best medical care on offer patients will still have long term damage to areas that have been affected by frostbite, this can include; numbness, sensitivity to cold and problems with nail growth
[1]. Prevention Frostbite Diagram It is important to be fully protected against harsh elements especially those at extreme temperatures. For a person going out in freezing weather must ensure that they are fully covered, they should dress in loose, light, comfortable layers in order to trap in any warmth made from their body temperature, wear moisture wicking socks as well as other layers to ensure insulation within weatherproof boots to protect the feet. Mittens or gloves should be worn to protect the hands and a ski mask, beanie or fleece hat covering as much of the face and ears as possible to protect the ears, nose and cheeks [6]. Another way of preventing the risk of frostbite is to refer to diagrams such as figure 2 to get an idea of how long to avoid being in the environmental conditions for and how long it would take before skin freezes. Conclusion Frostbite is a devastating condition, all though it's not necessarily life threatening in cases of deep frostbite it can be life inhibiting. Being easy to prevent it's heartbreaking that it can leave people without the ability to function with every day life, through awareness of how severe frostbite can possibly be and how easy it is to prevent, it has the ability to dramatically decrease the amount of extremities surgically removed annually. Those who live in extreme conditions and those planning to travel to them should read up on first aid as well as prevention in case of an incident that causes frostbite.
The essential points of the green-frosting are the concentration and absorbance value in each diluted which the process of serial dilution. The standard curve of Blue#1 and yellow #5 provide the equation of the trend-line in order to calculate the concentration in the diluted solution of the green frosting. The mole of dye in 100mL green stock solution, mole of dye in 5 gram and 1 gram of frosting, the Beer –Lambert Law, and the compare to amount desired by the company can be determined. The Beer-Lambert Law is the relationship between color and the concentration and equation A=Ebc. The “A” is absorbance, the “C” is a concentration in molarity, the “E” is a molar absorptivity and “b” is the path-length. The goal of the lab is to use the absorbance and the Beer-Lambert law to determine the amounts of blue#1 and yellow #5 in the green frosting.
Raynaud syndrome is an auto-immune disorder in which blood vessels in the digits constrict. It usually strikes females between the ages of eighteen and thirty. “Between three to five percent of people are affected.” (Harvard, 2003) There is no known cause or cure. (Segala et al, 2003) Clinical features primarily deal with (but are not limited to) the digits of the fingers. Other digits that may be affected include toes, nose, and ear lobes. Exposure to cold and emotional stress triggers the vasoconstriction of the digits. It was originally described by the Catholic, French physician Maurice Raynaud in 1862. In this condition, the vasospastic response is more frequently induced by exposure to cold temperatures and is often accompanied by digital color changes. After onset, a tri-color change [blanching (white), cyanosis (blue), and reactive hyperemia (red)] occurs. “Pallor (blanching) shows vasospasm and loss of arterial blood flow, cyanosis shows the deoxygenation of static venous blood, and rubor (red) shows reactive hyperemia following return of blood flow.” (Bowling, 2003) Theories for the causes of Raynaud syndrome include: arterial wall damage, connective tissue disease (CTD), or repetitive use of vibrational tools. (Ko, 2002)
worn down his "Grande Armee" was forced into a painful retreat through the deep freezing cold
At first the author paints a picture of a small village or town that is getting hit by a ice storm. The narrator shows how cold it is by commenting, “But the freezing rain kept coming. Tree branches glistened like glass. Then broke like glass. Ice thickened the windows until everything outside blurred” (Heynen 1). From this the reader can tell this isn't a regular snow day. Tree branches are freezing so much that they are just breaking like glass. Also the windows have become translucent from how thick the frozen ice is on them. The narrator also states, “Some farmers went ice-skating down gravel roads” (Heynen 1). The gravel road is so frozen that a person can ice skate on it. That itself shows how cold it is outside in this story. The reader should be able to tell
There are numerous risks for a patient during the preoperative stage of the perioperative journey. All patients undergoing a surgical procedure are at risk of developing perioperative hypothermia, although there are various factors which also further increase an individual’s susceptibility (Burger & Fitzpatrick, 2009). An individual’s body type can cause them more susceptible to heat loss during the perioperative period. The patient’s nutritional state and being malnourished, if the individual is female and is of low body weight therefore a high ratio of body surface area to weight and limited insulation to prevent heat loss, these are all factors which negatively affect heat loss and therefore increasing the individual’s risk of perioperative hypothermia (Lynch et al.,
occurs so the heat deep in the muscles is conserved. Since the vessels are now
The first was to see how long it would take to lower body temperature, and the next to decide how best to resuscitate a frozen victim. The doctors submerged a naked victim in an icy vat of water. They would insert an insulated thermometer into the victim’s rectum in order to monitor his or her body temperature. The icy vat proved to be the fastest way to drop the body’s temperature. Once the body reached 25 degrees Celsius, the victim would usually die.
Scientist think the antifreeze gene evolved after there was a mutation occurred during the duplication of the original gene.
Hypothermia is a common problem in surgical patients. Up to 70% of patients experience some degree of hypothermia that is undergoing anesthetic surgery. Complications include but are not limited to wound infections, myocardial ischemia, and greater oxygen demands. The formal definition of hypothermia is when the patient’s core body temperature drops below 36 degrees Celsius or 98.6 degrees Fahrenheit. Thus, the purpose of the paper is to synthesize what studies reveal about the current state of knowledge on the effects of pre-operative warming of patient’s postoperative temperatures. I will discuss consistencies and contradictions in the literature, and offer possible explanations for the inconsistencies. Finally I will provide preliminary conclusions on whether the research provides strong evidence to support a change in practice, or whether further research is needed to adequately address your inquiry.
Regulation- Blood vessels help maintain a stable body temperature by controlling the blood flow to the surface of the skin (Terfera, David, and Jegtvi)
Since ice fishing is a risky activity, it is crucial do certain things before attempting to step over the ice. This article explores five of them as follows.
The company provides innovative solutions to combat postoperative conditions such as hypothermia. Medical research indicates that 60 to 80 percent of all postoperative recovery room patients are clinically hypothermic. Hypothermia is caused by a patient’s exposure to cold operating room temperatures that are required by surgeons to control infection, and for the personal comfort of the surgeon. Hypothermia can also be a result of heat loss due to evaporation of the fluids used to scrub patients, evaporation from exposed bowel, and breathing of dry anesthetic gases. Dr. Augustine’s personal experience in the operating room convinced him that there was a need for a new system to warm patients after surgery.
“John first took leftover prescription painkillers and numbed his left foot in ice water to reduce impending pain. He then buried his foot in dry ice for six hours to induce severe frostbite and force surgeons to operate” (Adams, 2007).
What To Expect When You Have A Tooth Extracted When you have a decayed or broken tooth, your dentist usually prefers to save it rather than pull the tooth. In some cases though, it's necessary to pull a tooth. This may happen if the tooth isn't positioned properly and it pushes against other teeth. There may even be times when you have a toothache and can't afford a root canal and crown so you opt to have the tooth pulled. Although pulling is usually considered a last resort, it is an effective way to deal with a problem tooth.
Frigid, crisp, icy water stampeding over warm skin. In that few seconds of nothing but coldness; the body tenses and freezes, unable to move. Those few seconds there is nothing else, everything is centered upon the shock of the water. Only in those seconds can anyone even remotely be able to experience the paralyzing effect of amyotrophic lateral sclerosis. A trend that was started a few years ago spread over the internet where if someone didn’t dump a bucket of freezing water over himself/herself they should donate to the ALS foundation. This is known as the water bucket challenge. “Ironically, [... when] being doused with a bucket of ice water [it] feels a lot like having ALS" (Victora 1) so this challenge is perfect to spread awareness and