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Get out of the cold. Prioritize hypothermia treatment. Remove any constricting, clothing, footwear, or jewelry. Consider early treatment with ibuprofen or aspirin, and aloe vera. Make a rewarming decision: if less than 2 hours from advanced care do not rewarm on site.
Rapidly rewarm in water (36-40oC). Minimize warm ischemia time, avoid delays in advanced treatment when indicated. Grade the injury (clinically, consider bone scan/angiography). Begin treatment based on injury grade: antithromboxanes (aloe vera, Ibuprofen), prostacyclin (iloprost) and/or thrombolysis, consider hyperbaric oxygen if available, initiate wound care.
Continue wound care until healed or necrosis and amputation. Avoid reinjury. Manage long-term cold intolerance and pain as needed.
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Endorf FW, Nygaard RM. Social Determinants of Poor Outcomes Following Frostbite Injury: A Study of the National Inpatient Sample. J Burn Care Res Off Publ Am Burn Assoc. 2021 Nov 24;42(6):1261–5.
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Zhang Y, Song J, Huang G. Comprehensive Treatment of Single Finger Frostbite: A Case Study. J Burn Care Res Off Publ Am Burn Assoc. 2021 May 7;42(3):555–9.
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Ilomedin Package Insert. Bayer HealthCare
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