External Cooling
Level |
Direction |
Primary Outcome |
Patient/Process |
Setting |
Reference |
III
|
Supportive (Green)
|
Cooling rate
|
Patient
|
PH-Paramedic
|
DeGroot DW, Henderson KN, O'Connor FG. Cooling Modality Effectiveness and Mortality Associate With Prehospital Care of Exertional Heat Stroke Casualities. J Emerg Med 2023. Medline
|
III
|
Supportive (Green)
|
Core temperature
|
Process
|
SIM
|
Flouris AD., Friesen BJ., Carlson MJ., Casa DJ., Kenny GP. Effectiveness of cold water immersion for treating exertional heat stress when immediate response is not possible. Scand J Med Sci Sports 2015; 25(S1):229-39. Medline
|
III
|
Supportive (Green)
|
Ability of on scene cooling to achieve a core temp <102.2 F
|
Patient
|
PH-Paramedic
|
Jacobsen RC, Beaver B, Abo B. Out-of-Hospital Cold Water Immersion for Classic (Non-Exertional) Heat Stroke Guided by Real-Time Core Temperature Monitoring: A Case Series. Prehosp Emerg Care Nov 2022; 1–6. Medline
|
III
|
Supportive (Green)
|
Reduction in body temperature
|
Patient
|
PH-Paramedic & MD
|
Kido N, Tagami T, Otake K, et al. Exploring the Potential of CarbonCool® in Rapid Prehospital Cooling for Severe Heat Stroke. Prehosp Emerg Care February 2024; 1-17. Medline
|
III
|
Supportive (Green)
|
Rate of cooling
|
Process
|
|
Luhring KE., Butts CL., Smith CR., et al. Cooling effectiveness of a modified cold-water immersion method after exercise-induced hyperthermia. Journal of athletic training. 2016;51(11):946-951. Medline
|
III
|
Supportive (Green)
|
Successful discharge at 6 hours with no long-term adverse effects
|
Process
|
PH-Bystander
|
Rogerson S, Brearley M. Suspected exertional heat stroke; A case study of worker cooling in a hot and humid field environment. Work. July 2024. Medline
|
III
|
Supportive (Green)
|
Efficacy
|
Patient
|
PH-Paramedic
|
Young D, Everitt B, Fine B, Miramontes D. Immersive Cooling in the Prehospital Setting for Heat Stroke: A Case Report. Prehosp Emerg Care April 2023:1-3. Medline
|
X
|
Not Yet Graded (White)
|
Detection cold hyperthermia
|
Process
|
|
Lissoway JB., Lipman GS., Grahn DA., et al. Novel application of chemical cold packs for treatment of exercise-induced hyperthermia: A randomized controlled trial. Wilderness Environ Med 2015; 26(2):173-9. Medline
|
IV Fluid as a cooling agent
Level |
Direction |
Primary Outcome |
Patient/Process |
Setting |
Reference |
III
|
Supportive (Green)
|
Decrease in core body temperature
|
Process
|
ED-MD
|
Bursey MM, Galer M, Oh RC, Weathers BK. Successful Management of Severe Exertional Heat Stroke with Endovascular Cooling After Failure of Standard Cooling Measures. J Emerg Med 2019; 57(2):e53-6. Medline
|
III
|
Neutral (Yellow)
|
Mental status
|
Patient
|
|
Horseman MA., Rather-Conally J., Saavedra C., Surani S. A case of severe heatstroke and review of pathophysiology, clinical presentation, and treatment. J Intensive Care Med 2013; 28(6):334-40. Medline
|
X
|
Not Yet Graded (White)
|
-
|
Patient
|
|
Mallick A., Bodenham AR. MDMA induced hyperthermia: A survivor with an initial body temperature of 42.9 degrees C. J Accid Emerg Med 1997; 14(5):336-8. Medline
|