Fast Five Quiz: Can You Properly Identify and Treat Frostbite?

C. Crawford Mechem, MD, MS

Disclosures

January 15, 2015

First-degree frostbite has the following characteristics:

  • Insensate, central, white plaque surrounded by a ring of hyperemia;

  • Epidermal involvement;

  • Erythema; and

  • Mild edema.

Second-degree frostbite has the following characteristics:

  • Full-thickness skin freezing;

  • Clear blister formation with surrounding erythema;

  • Hard outer skin but resilient tissue underneath; and

  • Substantial edema.

Third-degree frostbite has the following characteristics:

  • Subdermal plexus freezing;

  • Hemorrhagic blister formation;

  • Blue-gray discoloration of the skin;

  • Deep, burning pain on rewarming, lasting 5 weeks; and

  • Thick gangrenous eschar formation within 2 weeks.

Fourth-degree frostbite has the following characteristics:

  • Involvement of muscle, bone, and tendons;

  • Frozen, hard, and avascular skin and tissue underneath;

  • Mottled tissue, with nonblanching cyanotic skin that eventually becomes dry, black, and mummified;

  • Relatively little pain experienced on rewarming; and

  • Minimal to mild post-thaw edema

For more on the presentation of frostbite, read here.

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