Management of non freezing cold injuries (NFCI)

management of non freezing cold injuries

Management of NFCI include:

• removing the affected limb and the patient from the cold and wet environment as quickly as possible
  
  
• slow rewarming (at 37–39°C ) is used as opposed to rapid rewarming seen in freezing cold injuries
  • rewarming should be carried out through exposure to warm air alone
  • NFCI must not be immersed in water
    
    
• analgesia
  • amitriptyline with or without pregabalin (traditional opiods and NSAIDs and gabapentin do not have the same efficacy)
    • titrate upward as necessary
  • regional analgesia - temporary relief can be achieved through spinal or epidural analgesia
    
    
• medical or surgical sympethectomy should be avoided since it is associated with medium- to long-term deterioration in patient symptoms
  
  
• surgery - should be delayed till the extent of the injury is understood (1)

Reference:

• (1) Heil K et al. Freezing and non-freezing cold weather injuries: a systematic review. Br Med Bull. 2016;117(1):79-93.