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Nonpharmacologic Treatment Clothing/ Prevent constriction Remove constricting items such as jewelry and rings because swelling will occur with thawing Hydration Patients are often clinically dehydrated due to cold diuresis, altitude, extreme activity Oral vs intravenous fluids should be used based on clinical picture Rewarming Fully or partially frozen tissue should be rapidly and actively rewarmed This should occur in a bath if possible, target temperature 37 to 39 C Povidone iodine or chlorhexidine should be added to prevent infection End point of warming is red/purple appearance, tissue becomes pliable Often takes 30 minutes, may take longer [22] Rewarming may be painful, parenteral analgesia is often required Return of sensation is a favorable prognostic sign Blister management Hemorrhagic blisters indicate injury into the reticular dermis Clear blisters suggest a more superficial injury pattern The wilderness medical society advises draining clear blisters, leaving hemorrhagic blisters intact [23] This process should be performed sterile, may require local anesthetic Hypothetically aids in wound care, tissue healing Dressings/ Wound care Goal: protect and prevent further tissue insult Affected limbs should be splinted, elevated, dressed in a loose dressing Padding between fingers/ toes is ideal Topical aloe vera cream/gel should be applied under the dressing Later, protective footwear should be used Nutrition Recovery requires a high-protein, high-calorie, individually tailored diets [24] Pharmacologic Treatment Analgesia Rewarming is painful, pain should be addressed NSAIDS All patients should be started on Ibuprofen for its anti-inflammatory affects in addition to analgesic 400 mg two or three times a day is a practical dose This can be increased up to 2400 mg/day Aspirin should be avoided due to theoretical blockade of some prostaglandins which promote wound healing Antibiotics Should be given if suspected or proven infection Prophylaxis is controversial

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AmpsDescription 10020ATrailer module, Electric rear sunshade 10140AMain headlights / Rain sensor / Light sensor / Electronic ride height control 10330ASTART-STOP system 10530AHiFi Amp, TV tuner, Video module 1155AABS (Anti-lock Brake System), DSC (Dynamic Stability Control) 1175ATelephone 1185AHead-Up Display (HUD), Air suspension system, HiFi Amp, TV tuner, Video module 11915AHead-Up Display (HUD) 1205AHead-Up Display (HUD), HiFi Amp, TV tuner, Video module 1215AHead-Up Display (HUD), Electric fan 1255ACD changer / Can Gateway module 12615AHiFi Amp, TV tuner, Video module 1325AABS (Anti-lock Brake System), DSC (Dynamic Stability Control) 137Electric fan 1395AFuel pump relay / Fuel pump control, Tire pressure control RDV 1415AMain headlights / Rain sensor / Light sensor / Electronic ride height control, Light module 14220AHeating / Independent aux.heater 14315AFront & rear cigarette lighter, 12V socket / Glove box charging socket (12V) 14415AFront & rear cigarette lighter, 12V socket / Glove box charging socket (12V) 14520ATrailer module 146Trailer module 14820ATrailer module 1535ABoot lid (tailgate) lock / Soft-close automatic for tailgate 1545ALight module 15515ABoot lid (tailgate) lock / Soft-close automatic for tailgate 1695AABS (Anti-lock Brake System), DSC (Dynamic Stability Control) 1705AHead-Up Display (HUD), HiFi Amp, TV tuner, Video module 171Front & rear cigarette lighter, 12V socket / Glove box charging socket (12V) 17520AHeating / Independent aux

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