Numbness. Pale tissue color is a sign of decreased oxygenation. may email you for journal alerts and information, but is committed E Encourage hourly movement of the affected digits to promote maximal restoration of function and to prevent contractures. The definitive treatment for frostbite is rapid rewarming in a water bath, but a frostbitten area that's been thawed and then freezes again is at risk for a much poorer outcome during the healing process.2,6 If the patient faces a risk for refreezing, then the frostbitten body part shouldn't be actively rewarmed.2,3,6 Whether to employ rapid rewarming of the body part depends on the patient's risk for refreezing due to delays in evacuation from a cold environment. Monitor for proper placement of tubes, catheters, and other devices. Don't break blisters that may develop. Frostbite. Depending on the severity of your symptoms, you may be told to go to an emergency room. Oral fluids can be given to alert patients; otherwise, intravenous saline. Rapid warming can induce ventricular fibrillation. 6. 8. Applying aloe vera cream or gel inhibits thromboxane and may promote wound healing.1,3,9, Expect significant edema to develop after frostbitten areas have been thawed. It is important for the nurse to remember to separate the fingers and toes in doing so. However, if exercise leads to exhaustion, systemic heat loss can increase the risk of frostbite and hypothermia. Fasciotomy is useful in treating compartment syndrome. It can also happen in the muscles and internal organs . McGraw-Hill Education; 2016. https://accessmedicine.mhmedical.com. To care for your skin after frostbite: Take all medications antibiotics or pain medicine as prescribed by your doctor. Use them in writing your short term or long term goals for your impaired tissue integrity care plan: Assessment is required to recognize possible problems that may have lead to Impaired Tissue Integrity and identify any episode that may transpire during nursing care. vascular stasis. Frostbite on fingertip Frostbite is an injury caused by freezing of the skin and underlying tissues. When tissue integrity is left untreated, it could cause local or systemic infection and ultimately lead to necrosis. For patients who have frostbite injury extending at least to the proximal interphalangeal joints, intravenous or intra-arterial administration of tissue plasminogen activator (tPA) may help salvage tissue if given within 24 hours of thawing. Philadelphia, Pa.: Elsevier; 2018. https://www.clinicalkey.com. Overview. Black, dead skin and tissues (gangrene) in severe cases. Serous exudate from a wound is a normal part of inflammation and must be differentiated from pus or purulent discharge present in the infection. T Tetanus prophylaxis can be given if there is associated trauma. A person viewing it online may make one printout of the material and may use that printout only for his or her personal, non-commercial reference. hn6_(| nMZ$iS [i7oHI8E!Hp)g4 5. 4. To limit tissue loss, oral ibuprofen should be started as soon as available and continued until surgery or complete healing. Although virtually any body part can be affected, the areas most often involved are the hands, feet, nose, and ears.1, Frostbite can develop in areas covered by clothing that offers inadequate protection from environmental conditions or is so tight it impairs circulation. Outline nursing interventions for patients with frostbite. The main components of a nursing care plan are: Patient health assessment (physical, emotional, cognitive, etc.) In below-freezing temperatures, avoid touching metal with bare hands. Johnson C, Anderson SR, Dallimore J, Winser S, Warrell DA, eds. Blebs develop an hour to few days after the process of rewarming. Monitor patients skin care practices, noting the type of soap or other cleansing agents used, the temperature of the water, and frequency of skin cleansing.Individualize plan is necessary according to the patients skin condition, needs, and preferences. After tissues have thawed, the more viable body parts can have erythema, edema, and blisters.1 If the affected areas remain dark and dusky, fail to form blisters, and develop a hard, black eschar, then tissue necrosis, gangrene, or mummification may ultimately result, requiring eventual amputation.1 An accurate prognosis about tissue viability may not be possible for several weeks or months while the freezing injury fully evolves.1, In all degrees of frostbite, pain may be extreme during and after thawing, and it can last days to months depending on the amount of tissue lost.1 Pressure from clothing or shoes as well as activity can worsen the pain; manifestations such as tingling and sensations of electric shock and burning have also been reported.2 Various intensities of sensory loss occur in the affected part for all degrees of frostbite and generally persist from 4 years to indefinitely.1, Because virtually all frostbitten body parts look similar while they're still frozen, the extent of damage can't be reliably determined until the body part thaws and the wounds evolve over time to reveal the line of demarcation between viable and necrotic tissue.1,4 This period can extend from 45 days to 3 months after the cold injury.1,3. Nursing Care Plan for Hypothermia 4 Altered Tissue Perfusion Nursing Diagnosis: Altered Tissue Perfusion related to hypothermia secondary to frostbite, as evidenced by insensitivity, blisters, severe pain in the affected area, hard or waxy-looking skin, and low body temperature. Besides providing a measure of pain relief, ibuprofen may support tissue viability by decreasing the production of thromboxane and other inflammatory mediators.3 Aspirin may also provide beneficial antiprostaglandin and analgesic effects for patients with frostbite.7,10 Severe pain is most effectively treated with parenteral opioid analgesics. B6Si,.90p Handford C, Buxton P, Russell K, et al. Whirlpool bath used to promote circulation in the affected part, debride necrotic tissue, permit normal circulation in the area and to help prevent infection. These measures raise the core temperature and improve circulation. Knowing how to recognize and intervene to competently treat frostbite is key to the best possible outcomes. Patients wound decreases in size and has increased granulation tissue. Although hyperbaric oxygen therapy has resulted in faster and more complete healing for many types of nonfrostbite wounds, it is not recommended in frostbite because of the risk of vasoconstriction from hyperoxemia. Another promising treatment option is the administration of vasodilators, particularly prostaglandins. The following measures can minimize the risk of frostbite: Protecting skin from moisture, wind, and exposure to cold, Increasing insulation and skin protection (e.g., adding layers of clothing, wearing mitts instead of gloves), Using supplemental oxygen in extremely hypoxic conditions (above 25,000 ft [7,500 m]), Avoiding alcohol, illicit drugs, or medications that reduce perfusion, Avoiding cold weather exposure during illness, Using chemical or electric hand and foot warmers, Avoiding the use of skin emollients, which do not protect against frostbite and may actually increase risk, Maintaining adequate hydration and nutrition, Minimizing blood flow constriction caused by tight clothing or footwear, Frequently assessing for extremity numbness or pain and warming extremities as soon as possible if there is concern that frostbite is developing, Recognizing frostnip or superficial frostbite before it becomes more serious. Yes, Recommendations based on patient-oriented outcomes? Nurses Pocket Guide: Diagnoses, Prioritized Interventions, and Rationales Quick-reference tool includes all you need to identify the correct diagnoses for efficient patient care planning. Identify a plan for debridement when necrotic tissue (eschar or slough) is present and if compatible with overall patient management goalsHealing does not transpire in the appearance of necrotic tissue. When the body temperature drops, the heart, nervous system, and other organs cant work normally leading to complete failure of the heart and respiratory system and eventually to death. 1. It is a series of measures that the nurse will do to address nursing concerns highlighted during the evaluation. Murphy, J. V., Banwell, P. E., Roberts, A. H., & McGrouther, D. A. The prostacyclin analog iloprost (Ventavis) inhibits platelet aggregation, dilates blood vessels, downregulates lymphocyte adhesion to endothelial cells, and may have fibrinolytic activity. Assess characteristics of the wound, including color, size (length, width, depth), drainage, and odor.These findings will give information on the extent of the impaired tissue integrity or injury. 10. She and Lawrence J. Jones are directors of the Appalachian Center for Wilderness Medicine in Morganton, N.C., and members of the Blue Mountain Ski Patrol in Palmerton, Pa. 17. Damage to deeper layers of the skin would result to injury of the tendons, muscles, nerves and bones. H]K0BlOoavA^u:/o:^MzKIWfx;x ), As with burn injuries, various degrees of frostbite can be present in the same body region. Wolters Kluwer Health For superficial frostbite that has been rewarmed, some people find it soothing to apply aloe vera gel or lotion to the affected area several times a day. Pain (severe, on passive motion, pressure, or stretch), Poikilothermia (skin that takes on the temperature of the environment). opioid agent for pain management during the rewarming phase. Accessed July 13, 2018. Substantial edema should be anticipated. Hypotension, metabolic acidosis, and dysrhythmias are complications of rewarming. 1. Rapid rewarming in the field should be performed only if definitive care is more than two hours away and refreezing can be prevented. The extent and depth of injury may affect pain sensations. %%EOF December 2019;30(4 suppl):S19S32, Available at:https://www.sciencedirect.com/science/article/pii/S1080603219300973?via%3Dihub. The basic principles of frostbite management are the same whether the patient is outdoors or in the hospital. iloprost, a prostacyclin analog, demonstrated significant efficacy in long-term tissue salvage when administered for severe frostbite in a European study when compared with other methods. What are my treatment options and the pros and cons for each? 13. Determine etiology (e.g., acute or chronic wound, burn, dermatological lesion, pressure ulcer, leg ulcer).Prior assessment of wound etiology is critical for the proper identification of nursing interventions that will guide nursing care. ), Cold injuries span the gamut from minor to life threatening, and can kill or cause permanent injury. 11. 2. Skin that feels abnormally firm or waxy. Gangrene is a condition that involves the destruction of body tissue caused by a major bacterial infection or a lack of blood supply. HMoA+qRU=4-Jq@B@H4OJY 0 0j`XO0YWM]}n@}:=Gg'@OFp-&5$>@HB@O =bq`]P0I9Er8M9NJc_ OH=a6 dg(,8"'=1;}/9h-1D ztLk^CEDygKf>Y(lRlf3U!D)/.,in~-nJllv1Lr{'cHb< X1\No6xl0(f1kt=jn%H3Y;[u}xC=:|sJ`K7+EU M The authors and planners have disclosed no potential conflicts of interest, financial or otherwise. The patient will verbalize understanding of the early signs of hypothermia such as shivering, pale or cool skin. A pilot study of the diagnosis and treatment of impaired skin integrity: dry skin in older persons. Performance Training Journal. Hypothermia is often caused by exposure to cold weather or immersion in a cold body of water. For more information about pain, please visit: Acute Pain Nursing Diagnosis & Care Plan. 5. Wilderness & Environmental Medicine. Pay attention to weather forecasts. Copyright 2020 by the American Academy of Family Physicians. Administer oxygen as indicated.Providing oxygenation to patients with hypothermia can help to maintain adequate oxygen levels in the blood, avoid further complications, and support the bodys overall function during the hypothermic state. Its availability is limited in the United States, but it can be administered in the field if available once it has been warmed. Hypothermia occurs when the body fails to produce heat during metabolic processes, in cells that support vital body functions. Gangrene Nursing Diagnosis & Care Plan. 3. A warm sleeping bag or blankets can be used to more effectively insulate the person from the cold. S Sterile dressings should be used to wrap the affected part if immediate medical help is available before rushing the patient to the emergency department for further care. 2011;22:156. Blisters (filled with clear fluid or possibly blood-filled in more severe cases). Nursing Care Plan for Heat Stroke 3 Nursing Diagnosis: Fluid Volume Deficit related to dehydration due to heat stroke as evidenced by temperature of 40 degrees Celsius, skin turgidity, dark yellow urine output, profuse sweating, and blood pressure of 89/58. If nonsteroidal anti-inflammatory drugs have not been given in the field, ibuprofen should be administered at a standard dosage until the frostbite wound is healed or surgery occurs. We may earn a small commission from your purchase. 8th ed. Impaired skin integrity related to frostbite as evidenced by open skin lesions GOAL With 2-3 days of nursing intervention, the patient will be able to: -Discussany altered sensation or pain at the site of tissue. We may earn a small commission from your purchase. This article reviews the pathophysiology of frostbite, prehospital and hospital management of a patient with frostbite, and prevention strategies for personal preparedness and patient education. 4. Before and during the process of rewarming the following should be done: When appropriate, the following procedures may be carried out in frostbite: It is also important to instruct the patient not to use tobacco because the vasoconstrictive effects of nicotine further reduces the already deficient blood supply to the damaged tissues. Provide warmed fluids such as tea or soup for alert patients.Warm fluids produce a heat source. To prevent worsening tissue damage, a frostbitten extremity should be rewarmed only if there is no risk of refreezing. Or it can be blue. It helps guide nurses throughout their shift in caring for the patient. And you can get these blisters on your hands. mg*vitRB"'^ 6. Perhaps the most important strategy for addressing frostbite is effective education, including hypothermia prevention. To aid the warming process, the water should be kept circulating. Diagnosis Expected outcomes (long and short-term) Nursing interventions and their rationale Implementation Evaluation (and any revision (s)) {f7m]VId39ol^le In the best possible case, this traveler's treatment in the local ED would include removal of his wet clothing; the application of warm, dry blankets around his body; and immersion of his feet and hands in water baths at temperatures of 37 C to 39 C (98.6 F to 102.2 F) for at least 30 minutes. In more severe cases, when the tissue has started to freeze, the skin may appear white and numb. Accessed May 27, 2021. The following are the most common symptoms of frostbite: Redness or pain in the affected area. However, tetanus prophylaxis should be administered. Skin wounds may be covered with wet or dry dressings, topical creams or lubricants, hydrocolloid dressings (e.g., DuoDerm), or vapor-permeable membrane dressings such as Tegaderm. Encourage the use of pillows, foam wedges, and pressure-reducing devices.These measures help redistribute and relieve pressure and prevent pressure injury. 21. Management of moderate-to-severe hypothermia takes priority over management of frostbite. 2010;3:1. Classify pressure ulcers by assessing the extent of tissue damage.According to the National Pressure Ulcer Advisory Panel, wound assessment is more reliable when classified in such a manner. Gonzaga T, Jenabzadeh K, Anderson CP, Mohr WJ, Endorf FW, Ahrenholz DH. Evaluate for the presence of frostbite, if the patient has had prolonged exposure to a cold environment.Severe hypothermia generates ice crystals to form inside cells. @ ! The toes and fingers, as well as the arms and legs, are frequently impacted by gangrene. Nursing Diagnosis Manual: Planning, Individualizing, and Documenting Client CareIdentify interventions to plan, individualize, and document care for more than 800 diseases and disorders. Goldsmith LA, et al., eds. Impaired skin integrity related to radiation therapy, Defining characteristics of the nursing diagnosis high risk for impaired skin integrity, Damaged or destroyed tissue (e.g., cornea, mucous membranes, integumentary, subcutaneous), Skin and tissue color changes (red, purplish, black). Telemedicine, including virtual Internet-based consultation, is being used in many areas to obtain expert assistance with patient management. The most helpful diagnostic studies for this include arteriography, technetium-99m scintigraphy (bone scan), and magnetic resonance imaging.3,7,11, I.V. Numbness and pallor resolve quickly after warming, and no long-term damage occurs. 1,2 Unfortunately, many of these risk factors are seen together in emergency department patients. Hyperoxemia will lead to peripheral vasoconstriction that can slow healing. Monitor patients continence status and minimize exposure of skin impairment site and other areas to moisture from incontinence, perspiration, or wound drainage.Prevents exposure to chemicals in urine and stool that can strip or erode the skin causing further impaired tissue integrity. "We tend to see frostbite, for example, when the temperature is 5 degrees Fahrenheit with minimal windchill," Dr. Kakar explains. Centers for Disease Control and Prevention. Nursing Interventions and Outcomes for the Diagnosis of Impaired Tissue Integrity in Patients After Cardiac Catheterization: Survey. To do this, the affected area is placed and soaked for 30 to 45 minutes in a 37 to 40 degree Celsius whirlpool until the tips of the injured part flushes. All rights reserved. Addressing hypothermia is the first priority, followed by evacuation to definitive care in a hospital that can provide the advanced monitoring, diagnostic studies, and interventions needed. As winter drags on and temperatures drop way down, your risk of cold-related injury like frostbite can go way up. Most cases of frostbite occur outdoors in various occupations and activities such as mountaineering, military training, and cold weather sports and in situations such as homelessness and unexpected exposure due to becoming lost or injured. If possible, an ibuprofen regimen should be initiated in the field setting. As hypothermia advances, vasodilation transpires, furthering heat loss. Briggs JK. Bandages may be applied to the frostbitten areas of your body. Metal coffee cans with long-burning candles. The rewarmed part should be protected. - May discharge when wound care plan established and patient on oral pain medication. Accessed July 13, 2018. If a body part is frozen in the field, it should be protected from further damage. Superficial frostbite: second-degree frostbite. In: Taylor and Kelly's Dermatology for Skin of Color. 15. Patient describes measures to protect and heal the tissue, including wound care. For more information, check out our privacy policy. Diagnosing frostbite is based on your signs and symptoms, skin appearance, and a review of recent activities in which you were exposed to cold. ZQ!8 P_S)Mm. 7@TR8b c\epR32^X9. Keep the patient and linens dry. 2023 Nurseslabs | Ut in Omnibus Glorificetur Deus! To avoid further mechanical injury, the affected part should be handled gently. Bandage the area with a loose, sterile dressing and place padding between affected digits. Escharotomy in this procedure an incision through the eschar is made. Teach patient and caregiver about skin and wound assessment and ways to monitor for signs and symptoms of infection, complications, and healing.Early assessment and intervention helpprevent the development of serious problems. Four degrees of frostbite are classically described. If possible, a frozen extremity should not be used for walking, climbing, or other activity until care has been obtained. 15. White or grayish-yellow skin. Other well-known contributing factors include wind chill, exposed skin, wetness, peripheral vascular disease or other causes of circulatory impairment, fatigue, substance misuse or abuse, altered consciousness or judgment, inadequate clothing or shelter, dehydration, smoking or nicotine use, immobility, and prior frostbite injury.1. Mayo Clinic does not endorse companies or products. These methods provide for a more gradual warming of the body. The primary cause of frostbite is exposure to freezing temperatures. Because adequate cutaneous blood flow is critical to maintaining warmth, any pathophysiologic condition associated with lack of blood flow or vasoconstriction contributes to the development of frostbite. Seek emergency medical care. Complete demarcation of tissue necrosis after frostbite may take up to three months. Immerse the affected part in 104F (40C) water for 15 to 30 minutes. Management of moderate-to-severe hypothermia takes priority over management of frostbite. Ackley and Ladwigs Nursing Diagnosis Handbook: An Evidence-Based Guide to Planning CareWe love this book because of its evidence-based approach to nursing interventions. Assess the patients peripheral perfusion at frequent intervals.Hypothermia initially precipitates peripheral vascular constriction as a compensatory mechanism to minimize heat loss from extremities. 19. For all other frostbite, after appropriate first aid and assessment for hypothermia, medical treatment may involve rewarming, medications, wound care, surgery and various therapies, depending on the severity of the injury. Move the person to a warmer place and shelter him or her from cold. 4. A collection of Practice Guidelines published in AFP is available at https://www.aafp.org/afp/practguide. The water temperature should be 96.8F to 104F (37C to 40C). Assessment is required to recognize possible problems that may have lead to Impaired Tissue Integrity and identify any episode that may transpire during nursing care. Make your tax-deductible gift and be a part of the cutting-edge research and care that's changing medicine. Mayo Clinic College of Medicine and Science, Mayo Clinic Graduate School of Biomedical Sciences, Mayo Clinic School of Graduate Medical Education, Mayo Clinic School of Continuous Professional Development, for video Mayo Clinic Minute: Why the risk of frostbite is greater than you think, Mayo Clinic on Incontinence - Mayo Clinic Press, NEW Mayo Clinic on High Blood Pressure - Mayo Clinic Press, Mayo Clinic on Hearing and Balance - Mayo Clinic Press, FREE Mayo Clinic Diet Assessment - Mayo Clinic Press, Mayo Clinic Health Letter - FREE book - Mayo Clinic Press, Financial Assistance Documents Minnesota, Mayo Clinic Minute: Why the risk of frostbite is greater than you think, Mayo Clinic Minute: Don't get bit by frostbite, Expert Alert: Don't let common winter injuries take you down. These include extracellular and intracellular ice crystal formation, cellular dehydration and shrinkage, derangement of intracellular electrolyte concentrations, endothelial damage, vasoconstriction, thrombosis, ischemia-reperfusion injury, and ultimately tissue necrosis.1,3 Multiple mediators, including thromboxane A2, arachidonic acid, bradykinin, histamine, and prostaglandins, contribute to the inflammatory response at the tissue level.3. An interdisciplinary team approach is essential. Moisture promotes evaporative heat loss. Frostbite. When providing initial care outdoors, secure shelter for the patient as soon as possible to minimize further exposure to the elements. It's now being touted in frostbite literature as a potential new therapy.1,12,13 At the time of this writing, however, I.V. Impaired Tissue Integrity & Wound Care Nursing Care Plan, Nursing Assessment and Rationales for Impaired Tissue Integrity, Nursing Interventions and Rationales for Impaired Tissue Integrity, All-in-One Nursing Care Planning Resource E-Book: Medical-Surgical, Pediatric, Maternity, and Psychiatric-Mental Health, Nursing Care Plans (NCP): Ultimate Guide and Database, Nursing Diagnosis Guide and List: All You Need to Know to Master Diagnosing, Wound care nursing: professional issues and opportunities. your express consent. Includes step-by-step instructions showing how to implement care and evaluate outcomes, and help you build skills in diagnostic reasoning and critical thinking. To help control swelling, elevate the affected extremity or body part. 4(LH;]-nhV Administer antibiotics as ordered.Although intravenous antibiotics may be indicated, wound infections may be managed well and more efficiently with topical agents. y tGy{yvTYusdEbA]XgroS(Eq^moVA,;?v!L_> s}( After tissue temperature drops far enough for freezing to occur, a cascade of pathophysiologic processes begins. In a normal setting, these defenses are adequate to defend the body from any threats. impairment. Wolters Kluwer Health, Inc. and/or its subsidiaries. Only in the Nursing Diagnosis Manual will you find for each diagnosis subjectively and objectively sample clinical applications, prioritized action/interventions with rationales a documentation section, and much more! Frostbite. The patients skin becomes warm and less pale. "[Those most at risk are] certain patients with diabetes, patients who have previous history of frostbite are prone to it, the elderly or your very young children, and also, for example, if you're dehydrated," he says. If the patient consents, taking a digital photograph of the affected areas can help to establish a baseline for trending after rewarming occurs and as the cold injury evolves. 3. See Also: Risk for Impaired Skin Integrity Care Plan . Supplemental oxygen, if available, is also recommended, especially if the patient is hypoxic or at high altitude.3. Don't walk on frostbitten feet, if possible. ANMC Frostbite Protocol candidacy since rewarming Frostbite tPA Initial frostbite consult: ask location Upper / Lower extremity Orthopedics . Exposure of the skin to temperatures below the freezing point this condition develops abnormally. Note and monitor the patients temperature.For alert patients, the oral temperature is regarded as more reliable than tympanic or axillary. Tissue plasminogen activator improves outcomes for deep frostbite extending to proximal interphalangeal joints if given within 24 hours. Recommended nursing diagnosis and nursing care plan books and resources. Check for electrolytes, arterial blood gases, and oxygen saturation by pulse oximetry.Acidosis may emerge from hypoventilation and hypoxia. 18. All-in-One Nursing Care Planning Resource E-Book: Medical-Surgical, Pediatric, Maternity, and Psychiatric-Mental HealthIncludes over 100 care plans for medical-surgical, maternity/OB, pediatrics, and psychiatric and mental health. The depth of tissue freezing determines the degree of frostbite injury and associated signs and symptoms. Assess patients nutritional status; refer for a nutritional consultation or institute dietary supplements.Inadequate nutritional intake places the patient at risk for skin breakdown and compromises healing, causing impaired tissue integrity. Moderate to severe hypothermia increases the risk for ventricular fibrillation, along with other dysrhythmias. vasodilation. Move the person to a warmer place and shelter him or her from cold. Remove wet clothes once you're indoors. Although outcomes are better with rapid rewarming, frostbite should be allowed to thaw spontaneously if rapid rewarming is not possible. Frostbite is not an inherently infection-prone injury, so antibiotic prophylaxis is unnecessary. Other recommended site resources for this nursing care plan: document.getElementById( "ak_js_1" ).setAttribute( "value", ( new Date() ).getTime() ); Gil Wayne ignites the minds of future nurses through his work as a part-time nurse instructor, writer, and contributor for Nurseslabs, striving to inspire the next generation to reach their full potential and elevate the nursing profession. 280 0 obj <> endobj Which is the most beneficial nursing intervention for this client? Protect exposed skin from contact with below-freezing temperatures, especially in windy conditions. These items may impair circulation. What increases the risk of frostbite? Image by: http://medicalimages.allrefer.com/large/frostbite.jpg, Maternal and Child Health Nursing (NCLEX Exams), Medical and Surgical Nursing (NCLEX Exams), Pharmacology and Drug Calculation (NCLEX Exams), Leukemia, Acute Nursing Care Plan & Management, Hepatic Encephalopathy Nursing Management, Benign Prostatic Hypertrophy or Hyperplasia Nursing Care. This content is owned by the AAFP. Fudge J. In the vascular stasis phase, vessels fluctuate between dilation and constriction. Frostbite should be treated only after the person's core body temperature is greater than 35 C (95 F). To minimize further tissue damage, skin should air dry or be gently blotted dry (not rubbed). Other factors include age, weight loss, poor nutrition and hydration, excessive moisture and dryness, smoking, and other conditions affecting blood flow. Regulate the environment temperature or relocate the patient to a warmer setting. 5 IUGd+&I5GcoPZm} FJ p1{e\^cN!l/.n w\5ltmOK[4m+$M,f17b,f*'TIFi! aQz:&{6|Q&8)#1Glk Ice crystals can form on skin surfaces, but not within the tissue. Besides being able to provide expert clinical management immediately after this cold injury, nurses need to understand the long-term complications and how these effects impact the patient's life. 2012;46:770. NANDA International Nursing Diagnoses: Definitions & Classification, 2021-2023The definitive guide to nursing diagnoses is reviewed and approved by NANDA International. The article references the current version of this guideline. The main goal of emergency management for frostbite is the restoration of normal body temperature.
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