RT Journal
A1 Crossman L
T1 REfrigeration in embolism
JF Journal of the American Medical Association
JO Journal of the American Medical Association
YR 1949
FD December 10
VO 141
IS 15
SP 1075
OP 1075
DO 10.1001/jama.1949.02910150041019
UL http://dx.doi.org/10.1001/jama.1949.02910150041019
AB To the Editor:— 
    In The Journal of Oct. 8, 1949, two articles on embolism involving the lower extremities followed the usual custom of ignoring refrigeration. Cold simultaneously inhibits pain, shock, thrombosis and tissue devitalization. Even when the arterial occlusion is in the pelvis or abdomen, packing of the legs in ice should follow diagnosis as an immediate routine in the hospital or, if necessary, at home. This method may keep the tissues viable for days or weeks, thus permitting delayed operation in cardiac or other critical conditions. After operation, moderate cooling serves as an adjuvant to anticoagulants in preventing thrombosis of small vessels. These and other considerations warrant repetition of the previous advice, "Refrigeration can extend the time limits and improve the results of embolectomy" (Am. J. Surg.68: 170, 1945; J. Internat. Coll. Surgeons8:438, 1945; J. A. M. A. 130: 185 [Jan. 261 1946).