Frostbite, treatment

Inositols, ie, hexaliydrobenzenehexols, are sugars that have received increasing study and are useful in the treatment of a wide variety of human disorders, including vascular disease, cancer, cirrhosis of the Hver, frostbite, and muscular dystrophy (269). Myoinositol esters prepared by reaction with lower fatty acid anhydrides are useful as Hver medicines and nonionic surfactants the aluminum and ammonium salts of inositol hexasulfate are useful anticancer agents (270). Tetraarjloxybenzoquinones are intermediates in the preparation of dioxazine dyes (266,271). The synthesis of hexakis(aryloxy)benzenes has also beenpubUshed (272). 

Health Hazards Information - Recommended Personal Protective Equipment Individual breathing devices with air supply neoprene gloves protective clothing eye protection Symptoms Following Exposure Inhalation of concentrated gas will cause suffocation. Contact will liquid can damage eyes because of low temperature. Frostbite may result from contact with liquid General Treatment for Exposure INHALATION remove to fresh air use artificial respiration if necessary. EYES get medical attention promptly if liquid has entered eyes. SKIN soak in lukewarm water (for frostbite) Toxicity by Inhalation (Threshold Limit Value) Data not available Short-Term Exposure Limits Data not available Toxicity by Ingestion Not pertinent (boils at -24.7°C) Late Toxicity Data not available Vtqtor (Gas) Irritant Characteristics Data not available Liquid or Solid Irritant Characteristics Data not available Odor Threshold Data not available. 

Health Hazards Information - Recommended Persoruil Protective Equipment Self-contained breathing apparatus for high vapor concentrations Symptoms Following Exposure In high vapor concentrations, can act as simple asphyxiant. Liquid causes severe frostbite General Treatment for Exposure Remove from Exposure, support respiration Toxicity by Inhalation (Threshold Umit Value) Not pertinent Short-Term Exposure Limits Not pertinent Toxicity by Ingestion Not pertinent Late Toxicity None Vapor (Gas) Irritant Characteristics Vapors are nonirritating to the eyes and throat Uquid or Solid Irritant Characteristics Not pertinent appreciable hazard. Practically harmless to the skin because is very volatile and evaporates quickly Odor Threshold 899 ppm. 

Contact of solutions of ethylene oxide with the skin of human volunteers caused characteristic burns after a latent period of 1-5 hours, effects were edema and erythema and progression to vesiculation, with a tendency to coalescence into blebs, and desquamation. Complete healing without treatment usually occurred within 21 days with, in some cases, residual brown pigmentation. Application of the liquid to the skin caused frostbite three of the eight volunteers were said to have become sensitized to ethylene oxide solutions. The undiluted liquid or solutions may cause severe eye irritation or damage. 

Phentolamine is used for peripheral blood circulation disorders, in particnlar in the beginning stages of gangrene, for treatment of trophic ulcers of the extremities, bedsores, and frostbite. Synonyms of this drug are regitine and dibazin. 

Because of their peripheral vasodilator effect, these drugs are used in the treatment of hypertension. They act beneficially in shock and frostbite by increasing peripheral circulation. Some, like phenoxybenzamine, also have cholinergic effects, indicating that these antagonists cross-react with the AChR. 

The exposed individual should be removed from the toxic environment and given 100% humidified supplemental oxygen with assisted ventilation as required. If hypoxia has been prolonged, the patient should be evaluated for neurologic sequelae and supportive treatment provided. Dermal exposure to liquid acetylene should be treated as indicated for frostbite injury. 

Victims should be moved immediately from the toxic atmosphere and receive 100% humidified supplemental oxygen with assisted ventilation as required. Patients with severe or prolonged exposure should be carefully evaluated for neurologic sequelae and provided with supportive treatment. Seizures may be controlled by administration of diazepam. If seizures cannot be controlled with diazepam or recur, pheny-toin or phenobarbital should be administered. Rewarming has been indicated for frostbite. On ocular exposure, the eyes should be rinsed for at least 15 min. 

Miller MB, Koltai PJ. Treatment of experimental frostbite with pentoxifylline and aloe vera cream. Arch Otol Head Neck Surg 1995 121 678-80. 

An interesting application is the use of bromelain in the debridement of third degree bums [112], in the treatment of blunt injuries to the musculoskeletal system [113], and in frostbite eschar removal [114]. It is also used as a potentiating agent in antibiotic therapy [115]. In laboratory medicine it is used extensively in blood group serology [116] and in immunology research [117]. 

Oxygen, Liquefied Safety goggles or faces shield, insulated gloves, long sleeves, trousers worn outside boots or over high-top shoes to shed spilled liquid. In all but the most severe cases (pneumonia) recovery is rapid after reduction of oxygen pressure. Supportive treatment should include immediate sedation, anticonvulsive therapy if needed and rest. Treat frostbite. Soak in lukewarm water. Treat frostbite burns. 

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