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Management of non freezing cold injuries (NFCI)

Last reviewed dd mmm yyyy. Last edited dd mmm yyyy

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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:

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