A University of Alberta team has developed a device to provide a more reliable, aseptic and economical treatment for frostbite, to be used in emergency rooms, shelters and even outdoors.
"Frostbite disproportionately affects opioid users, unhoused persons, people with mental illness and socially isolated people," says Matthew Douma, RN, adjunct professor of critical care medicine in the Faculty of Medicine & Dentistry and co-principal investigator of a project looking into frostbite cases in Alberta. "This is a condition that has been inadequately treated due to neglect and marginalization."
The device, known as a Precision Warm Water Circulator, is inspired by the sous vide cooking method, because it provides continuously circulating water at a precise temperature, in the case of the device between 37 C and 42 C. The device is portable, operated from a cart and can be supplied with a battery pack. The water basin is 20 centimetres deep.
"Evidence reviews show that the best possible treatment for frostbite is immediate or rapid immersion in circulating warm water," says Douma, who helps write treatment guidelines for the American Red Cross, the American Heart Association and the Heart and Stroke Foundation of Canada.
Douma says his team considered the alternatives and came up with the device as the solution to all of the other methods' problems: A tub of warm water cools too quickly. Running water from a tap is not always a consistent temperature, risking burns to the skin, and sinks are not sanitary. Tucking frozen hands under your arms — which you may have learned as a child — might warm hands that are cold but does not provide enough heat to remedy frostbite.
Exposed skin starts to freeze at 0 C. At first it starts to feel more firm to the touch, and will eventually freeze solid. The freezing process is usually painful though, dangerously, the pain disappears once the skin and its nerves are completely frozen. Damage to blood vessels and cells is caused by ice crystals in the tissue that interfere with circulation, ultimately leading to tissue death. Frozen tissue will turn black about three days after the injury.
Douma and his co-principal investigator Scott MacLean, assistant professor of emergency medicine at the U of A and physician at Edmonton's Royal Alexandra Hospital, reviewed Alberta hospital records over the past three years to track frostbite diagnoses.
They found more than 1,500 cases of frostbite per year across the province, including more than 100 each year that were serious enough to require amputation.
That's why Douma is making the device available through a non-profit social enterprise called Miteh Health Solutions at the cost-recovery price of about $7,000 per unit, with a "buy one, give one" model where devices purchased result in a device being donated to charities and not-for-profit organizations, like emergency shelters.
