Prehospital Frostbite Management With Iloprost: Case Reports of Two Helicopter Evacuations in Northern Canada

This case report describes iloprost infusion initiated in the prehospital setting to treat frostbite. Two cases were managed under a structured helicopter emergency medical services (HEMS) protocol during an extreme cold weather endurance race in the Yukon Territory in northern Canada. These cases demonstrate that intravenous iloprost delivery is operationally feasible in the prehospital setting. Administration was initiated on site and continued during helicopter transport following field rewarming and was completed in the hospital without complication. In remote or austere settings, field administration of iloprost can lower the time to treatment of frostbite injuries and may reduce warm ischemia time.