A 25-year-old man presents to the emergency department after being stranded in a snowstorm for several hours. He reports numbness and a tingling sensation in his fingers and toes. His temperature is 36.1°C (96.9°°F), pulse is 55/min, respirations are 18/min, and blood pressure is 115/70 mm Hg. On physical examination, his fingers and toes appear pale and cold to touch. There are no signs of blistering or necrosis. Sensation to touch is absent over the fingers bilaterally. Radial pulses are intact bilaterally though they are somewhat faint. Tetanus toxoid is administered.
Which of the following is the most appropriate initial management for this patient?
D) Immersion of the affected areas in warm water
The most appropriate initial management for mild frostbite injuries involves rewarming by immersing the affected area in warm water (37-39°C or 98.6-102.2°F) for 15-30 minutes. This helps to restore blood flow and minimize tissue damage. Analgesia is also important to manage pain during the rewarming process. Admission to the hospital may be necessary for observation and further wound care.
Answer choice A: Administration of intravenous antibiotics, is incorrect. Antibiotics are not indicated for the initial management of frostbite unless there are signs of infection.
Answer choice B: Application of dry heat packs to the affected areas, is incorrect. Dry heat can cause further tissue damage and should be avoided. Warm water immersion is the recommended method for rewarming.
Answer choice C: Immediate surgical debridement, is incorrect. Surgical intervention is not indicated in the initial management of mild frostbite. It is only considered in severe cases with necrosis or gangrene.
Answer choice E: Observation without intervention, is incorrect. Immediate rewarming is necessary to prevent further tissue damage and promote healing.
Key Learning Point
Management of mild frostbite injuries involves rewarming by immersing the affected area in warm water, analgesia, and admission to the hospital for observation and wound care.
