Adaira Landry's excellent presentation that won the 2015 EMCrit Conference Blast Competition
Ice water submersion for rapid cooling in severe drug-induced hyperthermia.
- Laskowski LK et al. Clin Toxicol 2015 Mar;53:181-184.
- The Poison Review's Review
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Scott Weingart
An ED Intensivist from NY. No conflicts of interest (coi).
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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.
[…] years EMCrit Critical Care Conference Blast Winner: Ice Water Baths for Rapid Cooling in Hyperthermia from Adaira Landry. […]
[…] years EMCrit Critical Care Conference Blast Winner: Ice Water Baths for Rapid Cooling in Hyperthermia from Adaira Landry. […]