Nonfreezing Cold-Induced Injuries
ARMY RESEARCH INST OF ENVIRONMENTAL MEDICINE NATICK MA THERMAL AND MOUNTAIN MEDICINE DIVISION
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Nonfreezing cold-induced injury NFCI is a clinical syndrome that results from damage caused to tissues exposed to cold temperatures at or above the freezing point of water 0 deg to 15 deg C 32 deg to 59 deg F. NFCI does not involve tissue freezing, which distinguishes it both clinically and pathologically from frostbite. The earliest descriptions of this syndrome had their origins in the military. Baron Dominique Jean Larrey, Napoleons chief surgeon, used the word congelation to describe the nonfreezing injuries together with frostbite casualties that occurred during the 1812 assault on Russia. Historically, infantry regiments have been decimated by cold and wet conditions, and many medical advances in understanding the pathophysiology and clinical course of NFCI have occurred after wars. However, it has been observed that the continuity of research tends to lag during the periods between major military campaigns. Developments in prevention of cold injury have flourished as new clothing and footwear have been designed, but little progress has been made in the treatment of NFCI. There is a rise in the number of people pursuing recreational activities in harsh environments, and as a consequence, civilian NFCI is becoming more prevalent. However, because many physicians are unfamiliar with NFCI, it may go undiagnosed during assessment of the cold-exposed victim. This results in unnecessary hospital admissions and potentially harmful and expensive therapy. Proper education and awareness of the hazards innate to the cold environment should mean that NFCI is preventable in most circumstances.
- Anatomy and Physiology
- Stress Physiology