Wilderness Medical Society practice guidelines for the prevention and treatment of frostbite: 2014 update

Scott E McIntosh; Matthew Opacic; Luanne Freer; Colin K Grissom; Paul S Auerbach; George W Rodway; Amalia Cochran; Gordon G Giesbrecht; Marion McDevitt; Christopher H Imray; Eric L Johnson; Jennifer Dow; Peter H Hackett; Wilderness Medical Society

doi:10.1016/j.wem.2014.09.001

Wilderness Medical Society practice guidelines for the prevention and treatment of frostbite: 2014 update

Wilderness Environ Med. 2014 Dec;25(4 Suppl):S43-54. doi: 10.1016/j.wem.2014.09.001.

Affiliations

¹ Division of Emergency Medicine, (Drs McIntosh and McDevitt). Electronic address: scott.mcintosh@hsc.utah.edu.
² Department of Emergency Medicine, Maine Medical Center, Portland, ME (Dr Opacic).
³ Everest Base Camp Medical Clinic, Nepal and Yellowstone National Park, WY (Dr Freer).
⁴ Division of Critical Care Medicine, Intermountain Medical Center (Dr Grissom).
⁵ Department of Surgery, Division of Emergency Medicine, Stanford University School of Medicine, Palo Alto, CA (Dr Auerbach).
⁶ College of Nursing and School of Medicine (Dr Rodway).
⁷ Department of Surgery (Dr Cochran), University of Utah, Salt Lake City, UT.
⁸ Health Leisure and Human Performance Research Institute, University of Manitoba, Winnipeg, Canada (Dr Giesbrecht).
⁹ Division of Emergency Medicine, (Drs McIntosh and McDevitt).
¹⁰ Warwick Medical School, University Hospital Coventry and Warwickshire NHS Trust, Coventry, UK (Dr Imray).
¹¹ Teton Valley Hospital, Driggs, ID, and Clinical Faculty, University of Washington, WA (Dr Johnson).
¹² Denali National Park and Preserve, AK (Dr Dow).
¹³ Division of Emergency Medicine, Altitude Research Center, University of Colorado Denver School of Medicine, Denver, CO, and the Institute for Altitude Medicine, Telluride, CO (Dr Hackett).

PMID: 25498262
DOI: 10.1016/j.wem.2014.09.001

Abstract

The Wilderness Medical Society convened an expert panel to develop a set of evidence-based guidelines for the prevention and treatment of frostbite. We present a review of pertinent pathophysiology. We then discuss primary and secondary prevention measures and therapeutic management. Recommendations are made regarding each treatment and its role in management. These recommendations are graded on the basis of the quality of supporting evidence and balance between the benefits and risks or burdens for each modality according to methodology stipulated by the American College of Chest Physicians. This is an updated version of the original guidelines published in Wilderness & Environmental Medicine 2011;22(2):156-166.

Keywords: aloe vera; frostbite; frostbite prevention; hypothermia; rewarming; thrombolysis.

Publication types

Practice Guideline

MeSH terms

Frostbite / classification*
Frostbite / physiopathology
Frostbite / prevention & control
Frostbite / therapy*
Humans
Practice Patterns, Physicians'*
Societies, Medical
Wilderness Medicine* / standards