American Board of Surgery Qualifying Exam (ABS QE) Practice Test

What is the first step in the management of frostbite?

1. Amputate the affected area

2. Apply pressure dressings

3. Rewarm the area rapidly with 40°C circulating water

4. Apply ice to the affected area

The correct answer is: Rewarm the area rapidly with 40°C circulating water

The first step in the management of frostbite involves rewarming the affected area rapidly with circulating water at a temperature of around 40°C. This method is preferred because it allows for a controlled and gradual rewarm, minimizing the risk of further tissue injury. Rapid rewarming helps to restore blood flow to the frozen tissues, reduce the extent of damage, and begin the healing process. Using circulating water provides an effective means of rewarming, as it can safely maintain a consistent temperature, unlike other methods such as applying direct heat sources, which may damage tissues further. This approach helps to significantly decrease pain levels and can prevent complications related to thawing that can occur if the tissues are not warmed properly. In contrast, methods such as ice application or pressure dressings can exacerbate the injury and contribute to additional tissue damage. Ice can lead to increased vasoconstriction and further decrease perfusion, while pressure dressings can impede blood flow, which is crucial for healing. Amputation is typically not considered until the extent of the injury has been assessed post-rewarming; it is not a first-line management step.