Frostbite is an injury in which the skin freezes and loses water. It primarily affects the nose, ears, cheeks, chin, fingers, and toes, areas which typically have reduced blood flow in cold conditions. Signs of frostbite include a cold tingling feeling followed by numbness, blisters, and the progression of skin color from red to purple to white. The biggest risks of frostbite are tissue death from a lack of nutrients, and the release of fluid into the tissues when the ice crystals in the skin melt as the body is rewarmed. Risks of frostbite include alcohol use, dehydration, exposure to air, and low physical fitness.
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1) Prodrome = nonspecific complaints such as mild headache and fatigue, general malaise, and fleeting aches and pains.
2) Chill (during which temperature rises) = sensation of being chilled and the onset of generalized shaking, despite temperature rising. Vasoconstriction and piloerection usually precede the onset of shivering. The skin is pale (from vasoconstriction). Once the body temperature reaches the new set point, the shivering ceases and a sensation of warmth develops.
3) Flush = cutaneous vasodilation occurs and the skin becomes warm and flushed.
4) Defervescence = stage of the febrile response is marked by the initiation of sweating. Not all people proceed through the four stages of fever development.
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