Frostbite Prevention -- Bundle Up!

Take it from someone who lived in Alaska for a year. Proper clothing and the good sense to come inside before the cold becomes painful are the best ways to avoid frostbite.

Robert Kennedy, MD, St. Louis Children's Hospital emergency medicine, took up residence in Alaska long enough to see his share of cold-exposed cheeks, ears and fingers.

"The recovery from frostbite is extremely painful," Dr. Kennedy says. "It is best to be avoided at all costs. Luckily, it can be -- as long as a few simple precautions are taken."

Starting with clothing, Dr. Kennedy reminds parents to protect their children's skin from exposure by supplying them with hats, gloves and scarves. He also recommends that families who want to stay active outdoors in the winter months invest in the latest synthetic fabrics. Unlike cotton, which absorbs moisture and can actually make you colder, many synthetic materials, such as GoreTex, are waterproof. And as Dr. Kennedy learned from bicycling to Alaska from Montana, staying dry is essential to staying warm.

Temperature, Dr. Kennedy warns, is not always the determining factor in creating conditions for frostbite. In fact, children and adults can suffer the initial stages of frostbite in above-freezing temperatures depending on how hard the wind is blowing and how wet they are.

"An important sign to look for," Dr. Kennedy adds, "is skin that is cold, white, painful, tingly or numb." If this is the case, bring your child inside immediately.

Knowing when to come in out of the cold is another way to prevent frostbite. But that is not as easy as it sounds because frostbite is followed by numbness of the affected area. Before that numbness sets in, however, there will be a period of pain. "If your child comes to you complaining that his fingers, ears, nose or cheeks hurt, it is time to get inside," Dr. Kennedy says.

The following steps outline how to treat frostbite:

• get the child indoors and remove all clothing that restricts circulation
• call your pediatrician immediately
• do not rub the frostbitten area, especially with snow or ice, since this can cause damage to thawing tissues
• place the entire frostbitten body part in very warm, but not hot, water (104-108 degrees F) until a pink flush returns to the frostbitten area (usually 30-60 minutes) and cover the rest of the body with blankets
• if warm water is not available, loosely wrap affected parts with blankets or towels
• do not re-warm frostbitten parts with heating pad, sun lamp, hot water bottle, stove, radiator or over a fire, since frostbitten skin is easily burned.
• acetaminophen or ibuprofen may be given for the pain
• offer warm, non-alcoholic fluids to drink
• place sterile gauze or cloth between affected toes or fingers to separate
• do not break any blisters
• if a blister is greater than the size of a nickel, or there are three or more blisters, inform your pediatrician within 12 hours
• do not allow children with frostbitten toes or feet to walk, but have them move their toes as soon as they are re-warmed