Online Medical Education on Emergency Department (ED) Critical Care, Trauma, and Resuscitation
Adaira Landry's excellent presentation that won the 2015 EMCrit Conference Blast Competition
Ice water submersion for rapid cooling in severe drug-induced hyperthermia.
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Scott Weingart. EMCrit Conference BLAST Winner – Ice Water Baths for Rapid Cooling of Hyperthermia. EMCrit Blog. Published on March 24, 2015. Accessed on May 22nd 2019. Available at [https://emcrit.org/emcrit/ice-bath-hyperthermia/ ].
Unless otherwise noted at the top of the post, the speaker(s) and related parties have no relevant financial disclosures.
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This Post was by the EMCrit Crew, published 4 years ago. We never spam; we hate spammers! Spammers probably work for the Joint Commission.
I presume the judges were screened for prejudice against hipsters before this talk blasted its way to victory? 😉
C
doesn’t everyone hate hipsters? they are like roaches.
I’m thinking a body bag would work well for this.
I was under the impression that it can be dangerous to cool a hyperthermic patient externally in such a rapid manner due to the instant vasoconstriction diverting blood from the skin and hence actually preventing heat loss. Obviously not the case? Cheers. (Nurse).
Hi John I thought the same as you so I did a bit of googling.
Seems like there’s a real worry that external cooling can cause vasoconstriction, blood rushing to the core, and slowing/paradoxical raising of the core temperature and BP. But the main mechanism that causes a raise in temperature when cooling, is shivering, and Adaira said her team cancelled out shivering by giving muscle relaxants.
Also what we were both thinking of probably comes from being warned us about sponge cooling patients; a really ineffective method in comparison to dumping patients in ice.
So these anaesthetised ice bath guys will get cooled (although, the most effective therapy in the papers I looked at was still paracetamol rather than anything fancier)
The two main sources I used were these two:
http://www.nice.org.uk/guidance/cg160/evidence/cg160-feverish-illness-in-children-full-guideline3
http://cid.oxfordjournals.org/content/31/Supplement_5/S224.full
Callum (Doctor – UK)
GOT IT! Many thanks Callum.
Great presentation. Love the low-tech solution to this complicated problem. Working in a remote and limited resource practice, it’s nice to know that there are still simple easy to use treatments that are well documented and supported by the established EM community.
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