Difference between revisions of "Cold injuries"

(Created page with "==Background== *Frostbite occurs only when ambient temperatures are well below freezing *Nonfreezing cold injuries occur due to exposure to wet conditions when temper >freezing ...")
 
 
(13 intermediate revisions by 3 users not shown)
Line 1: Line 1:
 
==Background==
 
==Background==
 
*Frostbite occurs only when ambient temperatures are well below freezing
 
*Frostbite occurs only when ambient temperatures are well below freezing
*Nonfreezing cold injuries occur due to exposure to wet conditions when temper >freezing  
+
*Nonfreezing cold injuries occur due to exposure to cold conditions above freezing  
  
==Nonfreezing Cold Injuries==
+
==Differential Diagnosis==
===Trench Foot===
+
{{Cold injuries DDX}}
====Background====
 
*Develops slowly over hours-days when foot is exposed to cold/wet conditions
 
*Reversible injury may progress to irreversible injury
 
  
==Clinical Features==
+
==See Also==
*Tingling/numbness is initial symptom
+
*[[Therapeutic hypothermia]]
*Foot appears pale, mottled, anesthetic, pulseless, and immobile
 
**Initially does not change after rewarming
 
*Hyperemic phase begins w/in hr after rewarming
 
**Assoc w/ severe burning pain and reappearance of proximal sensation
 
*As perfusion returns to foot over 2-3d edema and possibly bullae may form
 
*Anesthesia persists for weeks and may be permanent; gangrene may occur
 
  
==Treatment==
+
==References==
*Keep feet clean, warm, dryly bandaged, elevated
+
<references/>
*Monitor for signs of infection
 
  
===Pernio (Chilblains)===
+
[[Category:Environmental]]
====Background====
 
*Mild but uncomfortable inflammatory lesions of skin
 
**Caused by long-term intermittent exposure to damp, nonfreezing ambient temperatures
 
*Primarily a disease of women and children
 
 
 
====Clinical Features====
 
*Hands, ears, lower legs, feet most commonly affected
 
*Symptoms
 
**Tingling, numbness, pruritus, burning paresthesias
 
**Cutaneous manifestations appear up to 12hr after acute exposure:
 
**Localized edema, erythema, cyanosis, plaques, nodules
 
***May progress in rare cases to ulcerations, vesicles, and bullae
 
**Rewarming may result in formation of tender blue nodules which may persist for days
 
 
 
====Treatment====
 
*Affected skin should be rewarmed, gently bandaged, and elevated
 
*Nifedipine 20mg PO TID may be helpful as both prophylactic and therapeutic tx
 
*Topical corticosteroids and oral steroid burst have been shown to be useful
 
 
 
===Cold Panniculitis===
 
*Prolonged exposure to temp >freezing leads to mild necrosis of subcutaneous fat tissue
 
*Seen in children (popsicles) and women involved in equestrian activities
 
*Resolution may result in adipose fibrosis w/ cosmetic defects
 
**There is no treatment
 
 
 
===Cold Urticaria===
 
*Hypersensitivity to cold air or water which may lead to fatal anaphylaxis
 
*Treat similarly to urticarial lesions from other causes (i.e. antihistamines)
 
*Avoidance of cold is recommended
 
 
 
==Source==
 
Tintinalli
 
 
 
[[Category:Environ]]
 

Latest revision as of 00:24, 1 January 2017

Background

  • Frostbite occurs only when ambient temperatures are well below freezing
  • Nonfreezing cold injuries occur due to exposure to cold conditions above freezing

Differential Diagnosis

Cold injuries

See Also

References