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Updated: Dec 31, 2025

Prehospital Thrombolysis: A Manual from Berlin
Published on: November 26, 2013
Guidelines for Thrombolytic Therapy for Frostbite
Sean Hickey1, Amy Whitson2, Larry Jones2
1Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts.
Abstract:
The data are insufficient to support standardized treatment of all patients with frostbite with thrombolytic therapy. The following guidelines, however, should be applied to all patients with cyanosis persisting proximal to the distal phalanx (Grade 3 or 4 frostbite injury) and demonstrated loss of perfusion at or proximal to the middle phalanx immediately after rewarming.
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