Frostbite: a practical approach to hospital management

Extreme Physiology & Medicine

Christopher HE Imray³  Amalia Cochran⁸  Luanne Freer⁴  Scott E McIntosh¹  Caitlin EA Imray⁷  Katie Russell⁶  Pauline Buxton²  Charles Handford⁵ 

[1] Division of Emergency Medicine, University of Utah Health Care, Salt Lake City, UT 84112, USA;University Hospital Coventry & Warwickshire, Coventry CV2 2DX, UK;Warwick Medical School, The University of Warwick, Coventry CV4 7AL, UK;Everest ER, Himalayan Rescue Association, P.O. Box 4944, Kathmandu 44601, Nepal;Queen Elizabeth Hospital, Birmingham B15 2TH, UK;University of Utah, Salt Lake City, UT 84112, USA;Sheffield University Medical School, Sheffield S10 2TN, UK;University of Utah School of Medicine, Salt Lake City, UT 84132, USA

关键词: Iloprost;    TPA;    Heparin;    Thrombolysis;    Rewarming;    Hypothermia;    Frostbite;   

Others  :  802242
DOI  :  10.1186/2046-7648-3-7

 received in 2013-11-20, accepted in 2014-02-24,  发布年份 2014

【 摘 要 】

Frostbite presentation to hospital is relatively infrequent, and the optimal management of the more severely injured patient requires a multidisciplinary integration of specialist care. Clinicians with an interest in wilderness medicine/freezing cold injury have the awareness of specific potential interventions but may lack the skill or experience to implement the knowledge. The on-call specialist clinician (vascular, general surgery, orthopaedic, plastic surgeon or interventional radiologist), who is likely to receive these patients, may have the skill and knowledge to administer potentially limb-saving intervention but may be unaware of the available treatment options for frostbite. Over the last 10 years, frostbite management has improved with clear guidelines and management protocols available for both the medically trained and winter sports enthusiasts. Many specialist surgeons are unaware that patients with severe frostbite injuries presenting within 24 h of the injury may be good candidates for treatment with either TPA or iloprost. In this review, we aim to give a brief overview of field frostbite care and a practical guide to the hospital management of frostbite with a stepwise approach to thrombolysis and prostacyclin administration for clinicians.

【 授权许可】

   
2014 Handford et al.; licensee BioMed Central Ltd.

【 图 表 】

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