Purpose: To evaluate a patient for chilblains following cold exposure.			Citations with documentation. 34.01.20	Medal Project 2005. See disclaimer.
data	enter
Are you evaluating a patient who has been exposed to the cold? (Y or N)		:-):-):-)
Does the patient have skin lesions affecting the ears, fingers, heel, and/or toes? (Y or N)		:-):-):-)		1
Is the skin painful, erythematous, swollen and/or prurititic? (Y or N)		:-):-):-)		1
Have subcutaneous vesicles, bluish discoloration, tenderness, scaling and/or desquamation developed? (Y or N)		:-):-):-)		1
Have eschars formed with persistent pain? (Y or N)		:-):-):-)		1
Have the skin lesions reversed after removal from the cold and wet? (Y or N)		:-):-):-)		1
Does the patient have persistent pain after reversal of the skin lesions? (Y or N)		:-):-):-)		1
Does the patient have?
• peripheral vascular disease? (Y or N)		:-):-):-)		1
• spina bifida? (Y or N)		:-):-):-)		1
• Raynaud's phenomenon, vasculitis or cold agglutinins? (Y or N)		:-):-):-)		1
• improper clothing for cold weather? (Y or N)		:-):-):-)		1
• wet clothing? (Y or N)		:-):-):-)		1
calculate	result
data complete?	Yes
evaluation appropriate?	Yes	:-):-):-)
clinical findings seen with chilblains	6	out of 6 clinical findings
Are there findings suggesting more severe cold injury?	No
risk factors predisposing the patient to cold injury	5	risk factors