Cold Hands & Feet: Frostbite
When body parts get too cold, they can be injured or react in different ways. The most severe cold injury is called frostbite. When frostbite occurs, the tissues freeze and form ice crystals. With this, permanent damage occurs to the blood vessels and other structures. With frostnip ice crystals also form in the tissue, but it only occurs in the outer layers of the skin. No permanent damage results from frostnip. Immersion injury happens when hands or feet are exposed to water that is at or above freezing. Damage to the muscles and nerves can develop over a period of hours or days. This may result in permanent damage.

Frostbite shows up as white, hard or waxy tissue. Frostnipped tissue is also white, but not hard and it generally involves very small areas. Frozen parts have no feeling. They may tingle or feel like a “block of wood”.

Once frostbitten areas thaw, they may be painless or tingle. When they are rewarmed rapidly by warm water (preferred method), they may be painful. Over the next few days, the injured parts may be painful and swollen. Blisters may appear and most severely injured areas may turn black.

Immersion injuries are first red, then become pale and swollen. Numbness or painful tingling sometimes occurs. After the first few days, an immersed part becomes very red, tingle, swells, and may develop blisters or skin breakdown. If any of these signs or symptoms occurs, go immediately to an emergency facility.

Steps you can take until you are able to get to an emergency room are:

1. Remove wet clothing.
2. Do not try to thaw the frozen part unless you are in a warm place because refreezing causes more damage.
3. Treat frozen parts gently, don’t rub them.
4. Warm the frozen body parts in warm (not hot) water for about 30 minutes. Do not use dry heat (fireplaces, ovens or heating pads) to thaw frostbite.
5. Make sure to warm the entire body, not just the frostbitten parts. Wrap the rest of the body in blankets.
6. Place clean cotton balls between frostbitten fingers and toes after they have been rewarmed.
7. Do not break any blisters.
8. Loosely wrap rewarmed areas with clean bandages to keep from refreezing.
9. Ibuprofen may be used for pain.
10. Get to an emergency facility as soon as you can.

Prevention is very important:

1. Keep warm in cold weather.
2. Wear loose fitting clothes in layers. Wear insulated boots, thick socks and gloves or mittens (mittens are warmer than gloves).
3. Protect the face, hands, and feet, especially in windy, cold conditions.
4. Keep hands and feet dry.
5. Don’t wear extra socks if they make the boots too tight.
6. Do not smoke, as this causes poor circulation to the hands and feet.

References:  www.emedicinehealth.com  |  www.KidsHealth.org

Watch Out for Poison Ivy, Sumac and Oak!
Poison Ivy, Poison Sumac and Poison Oak represent a series of rashes called contact dermatitis. These occur when the skin comes into contact with the sap (oils) from one of these plants. This can occur in one of three ways:

1. Direct contact – Touching the sap of one of these plants. This can occur even if the plant is dead.
2. Indirect contact – Touching an object that has the sap on it such as animal fur, tools, sports equipment or clothing.
3. Airborne exposure – the oils from the plant are released when the plants are burned and may come into contact with you.

WHAT ARE THE SIGNS AND SYMPTOMS OF POISON IVY?
The oils from the sap penetrate the skin very quickly and set up a reaction. The initial response usually occurs 24 - 48 hours after the exposure. The initial signs are severe itching, redness and swelling, followed by blister formation. The rash usually occurs in streaks or lines where the plant came into contact with the skin. The blisters will crust over with time and may take ten days to heal. The fluid from the blister is not contagious. As long as the oils have been washed away, you cannot spread the rash by touching other body parts. The rash may be present in different times on different parts of the body. This is due to different skin thickness on different parts of the body.

Serious problems can occur from excessive swelling, especially the eyes, face, mouth, and genitals. The blisters can also ooze excessive fluid and cause dehydration. This is more likely to occur in infants and young children. The blisters can also become secondarily infected.

WHAT SHOULD YOU DO IF YOU THINK YOU MAY HAVE BEEN EXPOSED?
If you think that you may have been exposed to a poison plant, follow these simple steps:

1. Wash all the exposed areas with cold water as soon as possible. Preferably within 5 minutes because the oils penetrate the skin so quickly. Ideally, the entire body should be washed thoroughly with soap and cold water.
2. Clothing should be washed or dry cleaned. Any objects that may have come into contact with the oils should also be washed. If you bring clothing into the house, be careful not to allow it to contact carpeting or furniture.
3. Relieve the itching of mild rashes by taking a cool shower or by applying cool compresses. Over the counter treatments such as calamine lotion, Epsom salts, or Burrow’s solution may also improve the symptoms. Soaking in a lukewarm bath with oatmeal or baking soda may help dry oozing blisters.
4. More severe cases of rash may require treatment by a health professional. Prescription treatments may include steroids, creams or gels. With early treatment, blisters and more severe rash can sometimes be prevented. Unfortunately, over the counter steroid creams are not usually strong enough.

HOW TO YOU PREVENT GETTING THE RASH?
The easiest way to prevent a poison rash is to be able to identify the causative plants. Poison ivy grows as a vine in the East, Midwest and South. In the North and West it occurs as a shrub. Each leaf is formed from 3 leaflets. Poison oak has 3 - 5 leaflets per leaf. It occurs as either a shrub or vine in the West and as a shrub in the East. Poison sumac has 7 - 13 leaflets per leaf and grows in damp swampy places east of the Mississippi. As a general rule one can think ‘leafs of three beware of me”. If you are trying to rid your backyard of a poison plant, use an herbicide. Burning the plant will only release the oils in the smoke. If you know you are going to be in an area that may have poison ivy, always wear long pants, a long sleeved shirt, boots and gloves. Skin barrier creams such as Bentoquatom (Ivy Block) may be useful if applied prior to exposure. Although pets are not sensitive to poison plants, they can carry the oils on their fur and cause secondary contact to a human. Therefore try to avoid having pets run through areas with poison plants.

What to Do When Insects Sting
Insect stings can cause a range of reactions from mild localized skin irritation at the sting site to death. The insects responsible for most of the serious human reactions are the yellow jacket, honey bee, wasp and the hornet.

The yellow jacket is the most common venomous stinging insect. These insects nest near humans and scavenge for meats and sweets. Their colonies contain up to 500 bees. They become aggressive when their nests are disturbed and during late summer and autumn when the colony life cycle is ending.

Honey bees live primarily in man-made hives, in large (65,000 bees) colonies where they are used for honey production. They are the world’s most beneficial insect because they cross-pollinate fruits, vegetables and seed crops. They are not aggressive, but will sting if disturbed, leaving the stinger in the victim’s skin.

Paper wasps form small colonies (10 - 25 wasps). They build their nests around buildings. They are not typically as aggressive as bees, yellow jackets and yellow hornets; unless they are disturbed.

Yellow hornets live in colonies of about 1,500. They become aggressive when disturbed by activities such as hedge and shrub trimming.

The insect sting leaves venom in the skin of the victim. This can be poisonous. It may cause an allergic reaction or direct injury to the tissue. The most serious reactions are the allergic reactions. Most of the serious allergic reactions occur within an hour of being stung.

Insect stings in nonallergic people, although painful, usually do not cause serious problems. The problems that can occur may include swelling, muscle breakdown with kidney failure, and infections.

Most stings can be treated at home. Some will require medical attention. Call your doctor or go to an emergency facility if:

1. There is a large local reaction ( greater than 10 inches in diameter)
2. There is evidence of an infection
3. Any symptoms last more than 2 days

Go to an emergency facility immediately if you experience:

1. Difficulty breathing
2. Difficulty speaking
3. Swelling in the mouth or throat
4. Total body rash
5. Faintness or lightheadedness
6. More than 10 stings
7. The eyeball is involved

Self care at home begins with removing the stinger if it has remained in the skin. This can be done by scraping the stinger with a credit card. Grasping it with tweezers should be used only if necessary as this method can increase the amount of venom you could receive.

Next, apply ice for the pain. Consider taking an antihistamine for itching. Ibuprofen or acetaminophen may help decrease pain. Wash the area of the sting with soap and water and consider using an antibiotic ointment. If it has been more than 5 years since your last tetanus shot, make plans to get one in the next 2 - 3 days.

Prevention is important:

• Avoid nests and hives
• Take care when using outdoor motorized equipment, as that may stir up the insects
• If these flying insects are around, don’t swat them and leave the area
• When outdoors, avoid sugary drinks, brightly colored clothing, and strong fragrances, as these attract some insects
• If you have had a strong reaction to a sting in the past, have a self-administered injectable sting kit available, such as an “Epi-pen” and consider wearing a Medic Alert bracelet.

References:  e-medicine.com  |  Up-to-date.com

TOP  |  BACK

The contents of this website are for informational purposes only. This content is not
intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or a DocNow Urgent Care Clinic with any questions
you may have regardig a medical condition.