(1) Early stage (first phase). In this phase, the affected part is cold, numb,
and without pain.
Later stage (advanced phase).
(a) The limbs feel hot and burning.
(b) There are shooting pains in the affected area.
The affected area is pale with a bluish cast.
(d) The pulse strength in the affected area is decreased.
(e) Blisters, swelling, redness, hemorrhages, and gangrene may be
d. Frostbite. Frostbite is caused by the freezing of water in the skin and other
tissues. Frostbite occurs only when the flesh is exposed to freezing temperatures
[below 32F (0C)]. Frostbite usually occurs in areas most likely to be exposed to cold
conditions such as the cheeks, nose, ears, chin, forehead, fingers, hands, wrists, toes,
and feet. The depth and the severity of the injury depend upon the temperature and the
duration of exposure. The lower the temperature, the shorter the time required to
produce the injury. Frostbite is generally divided into two categories--superficial and
(1) Superficial frostbite. Superficial frostbite primarily involves injury to the
skin and the tissue just beneath the skin. Signs and symptoms of superficial frostbite
(a) Loss of sensation or numb feeling in the affected body part.
(b) Sudden whitening (blanching) of the skin in the affected area
followed by a momentary tingling feeling.
(c) A reddish (in light-skinned individuals) or grayish (in dark-skinned
individuals) area on the skin.
Freezing of superficial skin tissue may occur with superficial frostbite
(frostnip); however, there is no freezing of the deeper tissues.
(2) Deep frostbite. Deep frostbite occurs when the tissues below the skin
freeze. This may include the tissues of the muscles and bones. The blanching and
numbness of superficial frostbite always precede the development of deep frostbite. If
not properly treated, frostbite can result in the loss of fingers, toes, hands, or feet. It can
also result in gangrene--a life-threatening condition. Signs and symptoms of deep