Medicine for the Outdoors
Medicine for the Outdoors

Dr. Paul Auerbach is the world's leading outdoor health expert. His blog offers tips on outdoor safety and advice on how to handle wilderness emergencies.

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Wilderness Medical Society Practice Guidelines for Frostbite

Led by Scott McIntosh, MD and his colleagues, the Wilderness Medical Society has published "Practice Guidelines for the Prevention and Treatment of Frostbite" (Wild Environ Med 2011:22;156-166). These guidelines are intended to provide clinicians about best evidence-based practices, and were derived from the deliberations of an expert panel, of which I was a member. The guidelines present the main prophylactic and therapeutic modalities for frostbite and provide recommendations for their roles in patient management. The guidelines also provide suggested approaches to prevention and management of each disorder that incorporate the recommendations.

In outline format, here is what can be found in these guidelines:

  • Introduction
  • Methods
  • Pathophysiology of Frostbite
  • Classification of Frostbite
  • Prevention
  • Field Treatment and Secondary Prevention
    • Scenario 1: The Frozen Part Has the Potential of Re-freezing and Will Not Be Actively Thawed
    • Scenario 2: The Frozen Part Can Be Kept Thawed and Warm With Minimal Risk of Refreezing Until Evacuation is Completed
  • Immediate Medical Therapy – Hospital (or High Level Field Clinic)
  • Other Post-Thaw Medical Therapy
  • Conclusions
  • Disclosure
  • References

The science and medicine of frostbite and other cold-induced injuries are not without discussion, opinions, and some controversy. These Practice Guidelines are an excellent beginning point for persons interested in the topic.

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Tags: Climbing High , Hot & Cold

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About the Author

Dr. Paul S. Auerbach is the world’s leading authority on wilderness medicine.