Stephen L. Gaffin, PhD; John W. Gardner, MD, DrPH; Scott D. Flinn, MD
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Gaffin SL, Gardner JW, Flinn SD. Cooling Methods for Heatstroke Victims. Ann Intern Med. 2000;132:678-679. doi: 10.7326/0003-4819-132-8-200004180-00023
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Published: Ann Intern Med. 2000;132(8):678-679.
TO THE EDITOR:
Morbidity and mortality in heatstroke victims increase with the magnitude of the core temperature reached and the duration of high temperature until it is reduced to near-normal. Although rapid cooling is the most important intervention, widespread uncertainty surrounds the best cooling procedure: evaporative spray or ice-water treatment (1).
No studies have simultaneously compared these procedures for persons with exertional heatstroke and classic heatstroke. However, in patients with classic heatstroke and those with exertional heatstroke, ice-water cooling was twice as rapid in reducing the core temperature as the evaporative spray method (0.20 °C/min compared with 0.11 °C/min) (2). In more than 200 patients with exertional heatstroke with rectal temperatures up to 43.3 °C, cold- or ice-water treatment in the clinic reduced rectal temperatures to less than 39 °C in 10 to 40 minutes; no patients died or developed renal failure (Table) (3). When the evaporative spray method was used for 18 patients with classic heatstroke, 26 to 300 minutes was required to reduce the core temperature to 38 °C; 2 patients died (4).
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Print ISSN: 0003-4819 | Online ISSN: 1539-3704
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