management of non freezing cold injuries (NFCI)
Last reviewed 02/2021
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)
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