The management of a patient with frostbite includes:

b. Emersion of the tissue in a large water bath with a temperature of 40–42°C

The treatment of frostbite with rewarming should begin in the Emergency Room and not in the field. Gradual, spontaneous warming is generally inadequate and delayed thawing, or rubbing the injured part in ice or snow often results in marked tissue loss. Rapid rewarming should be achieved by immersing the tissue in a large bath of 40–42°C. The water should feel warm, but not hot to the normal hand. The skin should be gently but meticulously cleansed, air dried, and affected area elevated to minimize edema. Infection develops in only about 13% of urban frostbite victims, but half of these infections are present at the time of admission. Therefore, most clinicians reserve antibiotics for identified infections. Following rewarming, the treatment goals are to prevent further injury while awaiting demarcation of the irreversible tissue destruction. The use of sympathetic blockade, surgical sympathectomy, and intraarterial vasodilating drugs has generally been ineffective. Heparin, thrombolytic agents, and hyperbaric oxygen have also failed to demonstrate any substantial treatment benefit. The difficulty in determining the depth of tissue injury and cold injury has led to a conservative approach to the care of frostbite injuries. As a general rule, amputation and surgical debridement are delayed for 2–3 months unless infection with sepsis intervenes. The natural history of full thickness frostbite is gradual demarcation of the injured area with dry gangrene and mummification clearly delineating a nonviable tissue.