II. Pathophysiology

  1. Feet remain wet and cold (32-59 F or 0-15 C) for at least 2-3 days (common in homeless)

III. Symptoms

  1. Phase 1
    1. Initial foot numbness with as sensation of walking on wooden blocks
    2. Pale, white, Vasoconstricted skin
  2. Phase 2
    1. Skin becomes blue and mottled after cold exposure is removed
    2. Numbness continues
  3. Phase 3
    1. Foot becomes erythematous and edematous and severely painful
  4. Phase 4
    1. Peripheral sensory and motor deficits may persist weeks to years

IV. Signs

  1. Foot Odor with foot skin irritation, rash, ulcerations

V. Management

  1. See Hypothermia
  2. See Frostbite
  3. General measures
    1. Move patient to warm, dry environment
    2. Remove wet clothing
    3. Rewarm feet gently
    4. Air dry feet
  4. Treat other concurrent Cold Weather Injury
    1. Treat Hypothermia if present
    2. Treat Frostbite if present
  5. Painful Neuropathy
    1. Amitriptyline gradually titrate 10-30 mg up to 75 mg orally nightly

VI. Prevention

  1. Frequently change wet footwear
  2. Stay active tom promote extremity circulation

VII. References

  1. Civitarese and Sciano (2018) Crit Dec Emerg Med 32(2): 3-16

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Ontology: Immersion Foot (C0020941)

Definition (MSH) A condition of the feet produced by prolonged exposure of the feet to water. Exposure for 48 hours or more to warm water causes tropical immersion foot or warm-water immersion foot common in Vietnam where troops were exposed to prolonged or repeated wading in paddy fields or streams. Trench foot results from prolonged exposure to cold, without actual freezing. It was common in trench warfare during World War I, when soldiers stood, sometimes for hours, in trenches with a few inches of cold water in them. (Andrews' Diseases of the Skin, 8th ed, p27)
Concepts Injury or Poisoning (T037)
MSH D007102
ICD9 991.4
ICD10 T69.02
SnomedCT 111734005, 271331002
English Foot, Immersion, Immersion Feet, Feet, Immersion, immersion foot, Immersion Foot [Disease/Finding], immersion foot (diagnosis), Immersion foot, Immersion foot (disorder), Immersion foot (disorder) [Ambiguous], Immersion Foot
Dutch immersion foot, Loopgravenvoet, Voet, loopgraven-
German Nasserfrierung der Fuesse, Fuß-Kälte-Näße-Schaden
Portuguese Pé de imersão, Pé de Imersão
Spanish Pie de inmersión, pie de inmersión (trastorno), pie de inmersión, Pie de Inmersión
Swedish Immersionsfot
Japanese シンスイソク, シンスイアシ, 浸水足, 塹壕足
Czech noha - poškození chladem, Ponořená noha
Finnish Immersiojalka
Russian TRANSHEINAIA STOPA, STOPY OKHLAZHDENIE, IMMERSIIA STOPY, ИММЕРСИЯ СТОПЫ, СТОПЫ ОХЛАЖДЕНИЕ, ТРАНШЕЙНАЯ СТОПА
Polish Choroba White'a, Stopa namokła, Stopa okopowa, Stopa zanurzeniowa
Hungarian Lövészárok-láb (felázott láb)
Norwegian Not Translated[Immersion Foot]
French Pied d'immersion, Syndrome de White
Italian Piede da immersione

Ontology: Trench Foot (C0040831)

Concepts Injury or Poisoning (T037)
MSH D007102
ICD10 T69.02
SnomedCT 157718003, 212914001, 234015005, 111734005
English Foot, Trench, Feet, Trench, Immersion (trench) foot, Trenchfoot, Trench Foot, trenchfoot, trench foot (diagnosis), trench foot, trench feet, Trench foot, Trench foot (disorder), Trench Feet
Italian Piede da immersione, Piede da trincea, Piedi da trincea
Japanese 塹壕足, ザンゴウソク
French Pieds des tranchées, Pied des tranchées
German Schützengrabenfuß, Schuetzengrabenfuss
Czech Zákopová noha, syndrom zákopové nohy
Hungarian Lövészárok-láb (felázott láb)
Norwegian Skyttergravsføtter, Skyttergravsfot
Spanish pie de trinchera (concepto no activo), pie de trinchera (trastorno), pie de trinchera, Pie de trinchera, Pie de Trinchera
Portuguese Pé das trincheiras, Pé de Trincheira
Dutch loopgravenvoet, Immersion foot