U of A team repurposes culinary device to improve frostbite injury outcomes

Made-in-Edmonton solution for frostbite Connor Hogg has details on a new solution aimed at better treating frostbite patients.

University of Alberta researchers have created a device they believe could significantly reduce the number of frostbite cases that end in amputation.

The Frostbite Rewarming Device was inspired by data that suggested few of Alberta's growing number of frostbite injuries are being rewarmed appropriately, says Matthew Douma, a critical care adjunct professor who leads the Alberta Frostbite Care Collaborative.

There are multiple reasons for this, he knows from 16 years as an emergency department nurse, whether it be that an injured person is homeless and attends a hospital late, or that the most common way of rewarming an injury – a nurse manually supplying a series of buckets of warm water – is inefficient and imprecise.

"We didn't have a solution that was informed by the human factors or the workflow," Douma told CTV News Edmonton in a recent interview.

But effective rewarming can help preserve tissue and reduce the need for amputations and tissue grafts, so he saw an opportunity to improve both patient outcomes and treatment protocols.

"We can't even grade the injury and decide how to further treat it until we've rewarmed the limb fully. This allows us to do it rapidly and quickly, so we'd be able to get through more patients," Douma's undergrad research assistant, Daniel Tiwana, said.

"If a frostbite is bad enough… there will be some loss. However, this could mean the difference between losing your whole finger and only half of your finger."

What the team came up with is effectively a mobile basin that is kept at 50 C by an immersion circulator, the same device used in sous vide cooking.

The medical-grade stainless steel basin is equipped with a hose so that it can be filled at any hospital sink, as well as a faucet so it can be emptied into a low sink or floor drain.

The circulator shuts off at 50 C and the secondary power supply shuts off at 42 C to prevent burning.

Because a quarter of frostbite cases in Alberta consist of hand and foot injuries, the device consists of a second sink at foot level so both areas can be treated simultaneously.

The two basins are housed in a wheeled cart that can be moved anywhere needed, so long as there is a nearby electrical outlet. If an outlet is not available, the device can be powered for one hour by battery.

"With a device like this, that health-care professional can fill it, plug it in, get the patient sorted and settled, and actually go about maybe providing pain medication, assessing and treating other patients," Douma said.

"So really, it's almost like a force multiplier. It does a better job of rewarming, but also frees up health-care staff to do other roles."

The product is only a prototype at the moment and has not been used to treat humans. However, in trials on frozen animal limbs, the device has appeared promising, Douma's team says, having achieved target temperatures faster than traditional methods and produced lower outcome variability.

He hopes to get the device not only approved for use in hospitals, but also shelters and urgent-care facilities, which frequently see frostbite injuries.

"As soon as frostbite is discovered in that emergency shelter, if you can start this therapy, it could help prevent those amputations and the requirement for skin grafting and loss of function," Douma said. "They should still call 911… but if you can rewarm people at the site and then keep it warm, we believe the outcomes will actually be better."

With files from CTV News Edmonton's Connor Hogg