The classification of freezing cold injuries - a NATO research task group position paper
ABSTRACTIntroduction: Freezing cold injuries (FCI) are a common risk in extreme cold weather operations. Although the risks have long been recognised, injury occurrences tend to be sparse and geographically distributed, with relatively few cases to study in a systematic way. The first challenge to i...
| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
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Taylor & Francis Group
2023-12-01
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| Series: | International Journal of Circumpolar Health |
| Subjects: | |
| Online Access: | https://www.tandfonline.com/doi/10.1080/22423982.2023.2203923 |
| _version_ | 1797385591786045440 |
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| author | Arne Johan Norheim Wendy Sullivan-Kwantes Tuva Steinberg John Castellani Karl E. Friedl |
| author_facet | Arne Johan Norheim Wendy Sullivan-Kwantes Tuva Steinberg John Castellani Karl E. Friedl |
| author_sort | Arne Johan Norheim |
| collection | DOAJ |
| description | ABSTRACTIntroduction: Freezing cold injuries (FCI) are a common risk in extreme cold weather operations. Although the risks have long been recognised, injury occurrences tend to be sparse and geographically distributed, with relatively few cases to study in a systematic way. The first challenge to improve FCI medical management is to develop a common nomenclature for FCI classification. This is critical for the development of meaningful epidemiological reports on the magnitude and severity of FCI, for the standardisation of patient inclusion criteria for treatment studies, and for the development of clinical diagnosis and treatment algorithms.Methodology: A scoping review of the literature using PubMed and cross-checked with Google Scholar, using search terms related to freezing cold injury and frostbite, highlighted a paucity of published clinical papers and little agreement on classification schemes.Results: A total of 74 papers were identified, and 28 were included in the review. Published reports and studies can be generally grouped into four different classification schemes that are based on (1) injury morphology; (2) signs and symptoms; (3) pathophysiology; and (4) clinical outcome. The nomenclature in the different classification systems is not coherent and the discrete classification limits are not evidence based.Conclusions: All the classification systems are necessary and relevant to FCI medical management for sustainment of soldier health and performance in cold weather operations and winter warfare. Future FCI reports should clearly characterise the nature of the FCI into existing classification schemes for surveillance (morphology, symptoms, and appearance), identifying risk-factors, clinical guidelines, and agreed inclusion/exclusion criteria for a future treatment trial. |
| first_indexed | 2024-03-08T21:56:23Z |
| format | Article |
| id | doaj.art-cc76b2479e15438e90d8e50c8b3d2032 |
| institution | Directory Open Access Journal |
| issn | 2242-3982 |
| language | English |
| last_indexed | 2024-03-08T21:56:23Z |
| publishDate | 2023-12-01 |
| publisher | Taylor & Francis Group |
| record_format | Article |
| series | International Journal of Circumpolar Health |
| spelling | doaj.art-cc76b2479e15438e90d8e50c8b3d20322023-12-19T21:44:11ZengTaylor & Francis GroupInternational Journal of Circumpolar Health2242-39822023-12-0182110.1080/22423982.2023.2203923The classification of freezing cold injuries - a NATO research task group position paperArne Johan Norheim0Wendy Sullivan-Kwantes1Tuva Steinberg2John Castellani3Karl E. Friedl4National Research Center in Complementary and Alternative Medicine (NAFKAM), Institute of Community Medicine, UiT- The Arctic University of Norway, Tromsø, NorwayJoint medical services, Defence Research and Development Canada-Toronto Research Center, SessvollmoenNational Research Center in Complementary and Alternative Medicine (NAFKAM), Institute of Community Medicine, UiT- The Arctic University of Norway, Tromsø, NorwayU.S. Army Research Institute of Environmental Medicine, Natick MA USAU.S. Army Research Institute of Environmental Medicine, Natick MA USAABSTRACTIntroduction: Freezing cold injuries (FCI) are a common risk in extreme cold weather operations. Although the risks have long been recognised, injury occurrences tend to be sparse and geographically distributed, with relatively few cases to study in a systematic way. The first challenge to improve FCI medical management is to develop a common nomenclature for FCI classification. This is critical for the development of meaningful epidemiological reports on the magnitude and severity of FCI, for the standardisation of patient inclusion criteria for treatment studies, and for the development of clinical diagnosis and treatment algorithms.Methodology: A scoping review of the literature using PubMed and cross-checked with Google Scholar, using search terms related to freezing cold injury and frostbite, highlighted a paucity of published clinical papers and little agreement on classification schemes.Results: A total of 74 papers were identified, and 28 were included in the review. Published reports and studies can be generally grouped into four different classification schemes that are based on (1) injury morphology; (2) signs and symptoms; (3) pathophysiology; and (4) clinical outcome. The nomenclature in the different classification systems is not coherent and the discrete classification limits are not evidence based.Conclusions: All the classification systems are necessary and relevant to FCI medical management for sustainment of soldier health and performance in cold weather operations and winter warfare. Future FCI reports should clearly characterise the nature of the FCI into existing classification schemes for surveillance (morphology, symptoms, and appearance), identifying risk-factors, clinical guidelines, and agreed inclusion/exclusion criteria for a future treatment trial.https://www.tandfonline.com/doi/10.1080/22423982.2023.2203923Cold injury classificationextreme cold weathercold injurycold ischaemiaperipheral injuriesfreezing cold injury |
| spellingShingle | Arne Johan Norheim Wendy Sullivan-Kwantes Tuva Steinberg John Castellani Karl E. Friedl The classification of freezing cold injuries - a NATO research task group position paper International Journal of Circumpolar Health Cold injury classification extreme cold weather cold injury cold ischaemia peripheral injuries freezing cold injury |
| title | The classification of freezing cold injuries - a NATO research task group position paper |
| title_full | The classification of freezing cold injuries - a NATO research task group position paper |
| title_fullStr | The classification of freezing cold injuries - a NATO research task group position paper |
| title_full_unstemmed | The classification of freezing cold injuries - a NATO research task group position paper |
| title_short | The classification of freezing cold injuries - a NATO research task group position paper |
| title_sort | classification of freezing cold injuries a nato research task group position paper |
| topic | Cold injury classification extreme cold weather cold injury cold ischaemia peripheral injuries freezing cold injury |
| url | https://www.tandfonline.com/doi/10.1080/22423982.2023.2203923 |
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