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Frostbite fingers — DipIMC MCQ

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ModerateEnvironmental MedicineFrostbite fingersDipIMC

A climber has pale numb fingers after a winter route. There is no prospect of refreezing once evacuated and warm water is available at base. What is the most appropriate management?

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Correct answer: D — Rewarm in warm water if refreezing can be avoided and protect from trauma

Rewarm in warm water if refreezing can be avoided and protect from trauma is the best answer because frostbite rewarming is appropriate when refreezing risk is controlled. Give unrestricted crystalloid to normalise blood pressure is less appropriate because over-resuscitation can worsen bleeding when haemorrhage is uncontrolled; Immobilise every joint and delay departure for a detailed examination is less appropriate because prolonged packaging can delay definitive care. Defer treatment until a senior hospital doctor reviews the patient and Provide reassurance and reassess after transport are also suboptimal because they move attention away from the key pre-hospital priority.. The key DipIMC principle is to treat immediate reversible threats, communicate clearly and move the patient toward the right definitive care.

Reference: JRCALC Guidelines; Wilderness Medical Society guidance