A non-freezing cold injury that is caused by continual dampness and cold of the hands or feet.
The wet and cold causes vasoconstriction of the peripheral circulation in the hands or feet reducing blood flow, causing ischemia.
The skin can survive with reduced circulation for about 6 hours; after that it will die from ischemia.
The resulting injury is severe, painful, and lifelong.
Vasoconstriction deprives hands or feet of adequate blood supply for too long.
While wet and cold:
The extremities are cold, wet, numb, and macerated (wrinkled from being waterlogged).
The extremities become red, swollen, painful; may lead to gangrene or nerve damage.
Treatment: TREAT THE WHOLE PATIENT
Remove all wet clothing.
Get them dry & Keep them dry.
Reinsulate & Rewarm.
Hydrate & Feed with sickly sweet drinks – warm liquid Jello is best because it has lots of calories.
Do not allow them to get cold and wet again.
NSAID’s; eg. ibuprofen 800mg po tid, may be given with Tylenol for pain relief.
Keep hands and feet dry.
Change socks regularly.
Sleep in dry socks at night.
Make sure foot gear is not too tight, impairing circulation.
Do not tolerate cold, numb, wet extremities – Do something!
For more detailed information of trench/immersion foot injuries see the Jan/Feb 2005 issue of the Wilderness Medicine Newsletter, Non-Freezing Cold Injuries. Click on this link to learn more about or subscribe to the Wilderness Medicine Newsletter.
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