Frostbite in the mountains

Outside the lamp. The frames make themselves. Each photo is like a postcard. One more shot, then a second, a third… You took off your gloves for the photos. After a while you are no longer able to hold the phone. You lose feeling in your fingers. Clumsily trying to pull on gloves. And let it! The wind gusts one of them. You watch it fall off the ridge, bouncing over protruding rocks. And this is the second pair. The first, sweaty on the approach, now lies frozen in the flap of your backpack. Before you ski down, you can join the ranks of the unlucky ones who got frostbite in our post-skiing Tatras. Frostbite is a serious danger during winter excursions – even in the Polish mountains.

Noses, ears, lips, cheeks, fingers (and whole hands), toes (and feet) are, of course, particularly susceptible to frostbite – tissue damage caused by low temperatures.

DISCOVERY. Already frostbitten or not yet?

You said goodbye with the sight of a glove falling from the ridge. Fortunately, a colleague had an extra pair and shared them with you. What to do now? Put your hand under your arm. Anyone who has experienced this in the past knows well that now there will be PAIN. The pain slowly (tfu, it takes ages!) will give way. If, after a quarter of an hour or so, sensation and mobility fully return, and someone nice lends you gloves, you can continue with your plans. But if that doesn’t happen, and your skin is pale and hard, get ready to turn around! Remember – don’t warm the frozen area (even under the armpit!) if you do not have a guarantee that if it is frostbite, you will provide it with warmth and will not freeze again!

However, I did get frostbite

Proper warming involves rapid immersion of frostbitten tissues in water at 37-39°C for about 60 minutes (preferably with a disinfectant added, without touching the walls of the vessel). After drying, aloe vera gel is applied, sterile gauze pads are applied, to each finger individually, then gently wrapped with bandages. Immobilize a frostbitten hand e.g. On a sling, thus protecting against injury and acting as an anti-edema agent. In the case of the Tatra Mountains, however, it is best if you report to the hospital after descending to Zakopane. Frostbite is not a dermatological problem, but a circulatory one – the final prognosis is determined by the first 24 hours of treatment management, counting from the time the tissues are thawed!

Remember: thawing of tissues can occur only after you no longer expose them to the cold again!

Frostbite in the mountains – frostbitten fingers and toes (fot. GOPR)

Due to adverse weather conditions, frostbite is very often accompanied by hypothermia. Then it is much more important to recognize and inhibit the process of cooling of the body, because it is a life-threatening condition.

Always have with you

• dry socks and gloves for a change,
• Warm tea (preferably fruit tea with honey),
• chemical heaters, ,
• Insurance (remember that in Slovakia or the Alps, rescue operations are paid for),
• Lip protection stick,
• Also consider “taping” the nose and cheeks, as well as a protective cream (the issue of the effect of creams is not clearly medically proven).

PROFICTION how to protect yourself from frostbite

• Good boots and footgear. There are things that are not worth saving on. Stuffing an extra pair of socks into your shoes will reduce circulation and, as a result, you will frostbite your feet even more easily.
• Take care of hydration. Ideally, dissolve an electrolyte preparation in water. Don’t just limit yourself to strong coffee and black tea. Avoid alcohol. Dehydration impairs blood flow, then frostbite occurs faster.
• Do not smoke. Nicotine constricts blood vessels, contributing to frostbite.
• Do not touch metal with bare skin (m.In. shpej, ring, metal watch, glasses).
• Especially protect previously frostbitten body parts!
• Control sensation and mobility by moving your fingers and toes.
• Don’t allow your body to get chilled! Remember that if one of you has an accident, you need to be thermally protected while waiting for emergency services! That’s when the “fast and light” option will not work at all!
• Remember that not only temperature, but also humidity and wind promote hypothermia and frostbite! Protect yourself against them.
• In higher mountains, altitude will be an additional factor negatively affecting frostbite – there is an aspect of lower tissue oxygenation and increased platelet aggregation (clotting) and faster progressive dehydration.

Frostbite in the mountains – FIRST AID

• Do not rub the frostbitten area! Neither snow nor hand! By doing so, you will further damage the tissues.
• If you have not done so before, remove your wedding ring/ring! After thawing, swelling will develop.
• Don’t heat frostbitten tissues over a stove burner, lighter flame or under a hair dryer.
• When the warmed tissue begins to swell, there will be a risk that you won’t be able to fit your foot into your shoe.
• Do not puncture blisters! Exception – the surrounding bladder e.g. Toe (pressure on tissues = ischemia) or blister on the foot and need to go downhill. We treat the bladder as a natural dressing. Puncture of the bladder = opening of the “wound” and pain. However, if your blister is about to ‘bust’ in your shoe, consider wiping it with a gauze pad soaked in alcohol, piercing it with a needle and applying an “artificial skin” type patch (fot. Compeed). Blisters appear only in stage II and III frostbite, after warming up, so already downstairs.
• Take 400 mg of Ibuprofen. Preferably in a gel capsule so that it takes effect quickly, or consider taking 300 mg of acetylsalicylic acid (e.g. Aspirin). The guidelines for this are currently under revision.
• Protect frostbitten tissues from injury!
• Tissue thawing is best done when you will not expose it to the cold again. Don’t do it in the shelter, but only after going downhill.
• Do not warm the frostbitten area (even under the armpit!) if you have no guarantee that you will be able to keep him warm and he will not freeze again!
• Protect frostbitten tissues from injury!

Remember!

Many people are allergic to acetylsalicylic acid! It affects blood clotting. In the event of an injury during the descent, it will be a disadvantage.

This text signals the most important aspects of frostbite prevention and first aid. However, it does not exhaust the topic. If you’re serious about winter mountain activities, it’s a good idea to get hands-on training in mountain first aid – such as. organized in Bethlehem
(Facebook: Medicine in the Peaks and Depths). See you in the Tatras!