Like burns, frostbite severity ranges from Stage 1 \u2014 frostnip \u2014\u00a0 to 4, where the skin and underlying tissue is usually dead and has turned black, similar to an electrical burn.<\/p>\n
At stages 3 and 4, some sort of surgical reconstruction or amputation is usually needed, said Dr. Izadpanah.<\/p>\n
He says the frostbite can only be evaluated once the area has been warmed up.<\/p>\n
\u201cComing off the cold weather, everything looks cyanotic and dead. You warm it up and see what stage it\u2019s becoming, what kind of blisters are forming, what is the extent of the damage,\u201d said Izadpanah.<\/p>\n
The iloprost treatment protocol is used on patients who have a Stage 2 or 3 frostbite.<\/p>\n
Even though the vessels are damaged, the medication keeps the blood flowing, which prevents the tissue from dying and helps it heal.<\/p>\n
\u201cSo the chance of amputation decreases substantially,\u201d said Izadpanah.<\/p>\n
![\"Dr.](\"https:\/\/www.newsbeep.com\/ca\/wp-content\/uploads\/2026\/03\/1ab3fe7d1bb20464a2d305df3efc2d66.jpeg\"\/)
<\/p>\n
(Etienne Gosselin\/CBC)<\/p>\n
In the past, if the frostbite was Stage 3, the risk of amputation could run as high as 60 or 70 per cent.<\/p>\n
\u201cWith the iloprost, some of the studies have shown it goes down to 10 per cent,\u201d said Izadpanah.<\/p>\n
The use of iloprost for frostbite is not yet approved by Health Canada, so it requires special approval. In the last year or two, Izadpanah says most major centres in Quebec have access to it. But the doses need to be ordered in advance.<\/p>\n
\u201cIf you ask for it come the winter, it\u2019s way too late. So we sent the request last year, winter, for this year\u2019s winter,\u201d he said.<\/p>\n
Particularly rough winters<\/p>\n
While the number of frostbite amputations in Montreal seems to be going down, frostbite is still a concern for those living on the streets.<\/p>\n
Even in cases where amputation is initially avoided, the blood vessels remain fragile.<\/p>\n
\u201cA limb that has been affected by a frostbite is always more susceptible to having another frostbite. Because the damage has been done,\u201d said Izadpanah.<\/p>\n
About 15 to 20 per cent of Montreal\u2019s homeless population live outside, says James Hughes, the president and CEO of the Old Brewery Mission. Some live in encampments or abandoned buildings. Others use Metro stations or hospital emergency rooms as temporary shelters.<\/p>\n
\u201cSo they are moving around a lot outside and are naturally exposed to cold weather more than people who are not [homeless],\u201d said Hughes.<\/p>\n
This winter, the City of Montreal added hundreds of spaces at temporary warming centres. Hughes says the drop in amputations is \u201cterrific\u201d and fears the number could have been much higher if not for the extra spots.<\/p>\n
\u201cThey\u2019ve absolutely had a positive impact,\u201d he said.<\/p>\n
![\"A](\"https:\/\/www.newsbeep.com\/ca\/wp-content\/uploads\/2026\/03\/878ba76dc7a9fb43e70f40c2b327fcf3.jpeg\"\/)
<\/p>\n
(Charlotte Dumoulin\/Radio-Canada)<\/p>\n
The Montreal health network includes five regional health authorities as well as the CHUM and MUHC. Of those, the regional health hubs that serve the West Island, the central-western part of Montreal and the east end said they did not track frostbite amputations.<\/p>\n
The CHUM and the three hospitals overseen by the CIUSSS du Nord-de-l’\u00cele-de-Montr\u00e9al performed about 75 per cent of the amputations on the island of Montreal since 2018. The rest were done at the MUHC and the CIUSSS du Centre-Sud-de-l’\u00cele-de-Montr\u00e9al.<\/p>\n
Nearly half of the frostbite amputations occurred in 2023 and 2025.<\/p>\n
Historical weather data shows both years had several days of frigid temperatures and bone-chilling wind chill. Winter 2025 was particularly brutal, with back-to-back storms last February, which brought nearly 75 centimetres of snow over five days.<\/p>\n
‘Loss of identity’<\/p>\n
In the homeless population, poor health is undeniable.<\/p>\n
Chronic health conditions such as diabetes are common, which can make people more susceptible to frostbite. Drug or alcohol dependence can also dull the pain of frostbite and delay detection, said Hughes.<\/p>\n
Although the Old Brewery Mission\u2019s front-line staff are trained to spot frostbite quickly, it\u2019s often too late.<\/p>\n
\u201cWe see it anecdotally here all the time,\u201d said Hughes. \u201cWe have people here in our caf\u00e9 and in our emergency services who have lost limbs.\u201d<\/p>\n
He\u2019d like to see the city invest in more medical staff who can work directly out of homeless shelters to catch infections and other health ailments early.<\/p>\n
Although there are psychiatric services available on-site at many homeless shelters, there isn\u2019t an equivalent for physical health.<\/p>\n
\u201cWe need to have primary care here, that would be incredibly helpful because people often don\u2019t get referred easily. It\u2019s very hard to give a homeless person an appointment on the other side of town.\u201d<\/p>\n
![\"The](\"https:\/\/www.newsbeep.com\/ca\/wp-content\/uploads\/2026\/03\/3399e67402a971d635ecd88ce9a415dd.jpeg\"\/)
<\/p>\n
The executive director of La Maison du P\u00e8re, Ja\u00eblle B\u00e9garin, said an amputation can further complicate what is already a difficult life for someone who is experiencing homelessness. She says in some cases, it can lead to suicidal thoughts. (Etienne Gosselin\/CBC)<\/p>\n
Maison du P\u00e8re has 30 beds to help support individuals who require extra health care, including patients who had an amputation due to frostbite.<\/p>\n
Since January, the organization has helped care for five people who experienced severe frostbite. Two of them remain under observation to see if amputation can be avoided, said Ja\u00eblle B\u00e9garin, who runs the shelter.<\/p>\n
Their nurses can change dressings, make sure people are taking their medication and support people who are receiving rehabilitation.<\/p>\n
B\u00e9garin said the impact of an amputation can be profound. Some people who were on a waiting list for housing may need to start from scratch if they now need adapted housing.<\/p>\n
The loss of a digit, foot or hand can also magnify mental health issues.<\/p>\n
\u201cIt\u2019s yet another burden on top of homelessness and very often there\u2019s a loss of identity that comes with it,\u201d said B\u00e9garin. \u201cThe person no longer recognizes themselves and has to relearn how to rediscover themselves in a different way.\u201d<\/p>\n
While both Hughes and B\u00e9garin say the drop in amputations is encouraging, they argue the use of warming shelters is a Band-Aid solution.<\/p>\n
They say the city needs to invest in more housing, so people don\u2019t end up on the streets in the first place.<\/p>\n
Izadpanah agrees.<\/p>\n
\u201cIt\u2019s really a social issue,\u201d he said. \u201cSo having more support outside for this fragile population, I think, is really the key to decreasing frostbite.\u201d<\/p>\n","protected":false},"excerpt":{"rendered":"Winter can be tough to bear. Even more so if you\u2019re homeless. If there is no place to…\n","protected":false},"author":2,"featured_media":559649,"comment_status":"","ping_status":"","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[194292],"tags":[216427,180223,49,48,114653,216428,2338,216429],"class_list":["post-559648","post","type-post","status-publish","format-standard","has-post-thumbnail","category-montreal","tag-ali-izadpanah","tag-amputation","tag-ca","tag-canada","tag-frostbite","tag-james-hughes","tag-montreal","tag-regional-health-authorities"],"_links":{"self":[{"href":"https:\/\/www.newsbeep.com\/ca\/wp-json\/wp\/v2\/posts\/559648","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.newsbeep.com\/ca\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.newsbeep.com\/ca\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.newsbeep.com\/ca\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/www.newsbeep.com\/ca\/wp-json\/wp\/v2\/comments?post=559648"}],"version-history":[{"count":0,"href":"https:\/\/www.newsbeep.com\/ca\/wp-json\/wp\/v2\/posts\/559648\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.newsbeep.com\/ca\/wp-json\/wp\/v2\/media\/559649"}],"wp:attachment":[{"href":"https:\/\/www.newsbeep.com\/ca\/wp-json\/wp\/v2\/media?parent=559648"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.newsbeep.com\/ca\/wp-json\/wp\/v2\/categories?post=559648"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.newsbeep.com\/ca\/wp-json\/wp\/v2\/tags?post=559648"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}