• Sarah L Khan, Raj Parikh, Theodore Mooncai, Sukhmeet Sandhu, Raagini Jawa, and Harrison W Farber.
• Boston Medical Center, Department of Internal Medicine, United States of America. Electronic address: Sarah.Khan@bmc.org.
• Am J Emerg Med. 2019 Aug 1; 37 (8): 1601.e31601.e51601.e3-1601.e5.

AbstractThe treatment of frostbite injuries has undergone a radical change over the past decade with a shift from supportive therapy and observation towards early and aggressive medical intervention with thrombolytics and vasodilators. Institutions that have implemented evidence-based protocols have significantly decreased their amputation rates (Bruen et al., 2007; Lindford et al., 2017a; Twomey et al., 2005). We present the case of a middle-aged male treated for frostbite of multiple fingers on both hands. Because there was no treatment protocol at our institution, there were multiple delays in the patient's care including imaging and initiation of intravenous (IV) prostanoids. This case illustrates the deleterious effects of delays in treatment and strongly suggests that all facilities located in areas of cold exposure should have protocols in place for such an occurrence.Copyright © 2019 Elsevier Inc. All rights reserved.

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