Cooling Modality Effectiveness and Mortality Associate With Prehospital Care of Exertional Heat Stroke Casualities

DeGroot, David W.; Henderson, Kaemmer N.; O’Connor, Francis G.

doi:10.1016/j.jemermed.2022.12.015

Cited by 7 publications

(8 citation statements)

References 21 publications

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“…Survivors who were cooled at an inadequate rate had a 4.57 times risk of medical complications. A recent study by DeGroot et al (48) demonstrated the effectiveness of ice sheets (bed sheets soaked in ice water) as a possible alternative for EHS when CWI is not available. A cooling rate of 0.16°C/min was achieved, which is comparable to CWI.…”

Section: Clinical Managementmentioning

confidence: 99%

Management of Heat-Related Illness and Injury in the ICU: A Concise Definitive Review

Barletta,

Palmieri,

Toomey

et al. 2024

Critical Care Medicine

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Objectives: The increasing frequency of extreme heat events has led to a growing number of heat-related injuries and illnesses in ICUs. The objective of this review was to summarize and critically appraise evidence for the management of heat-related illnesses and injuries for critical care multiprofessionals. Data Sources: Ovid Medline, Embase, Cochrane Clinical Trials Register, Cumulative Index to Nursing and Allied Health Literature, and ClinicalTrials.gov databases were searched from inception through August 2023 for studies reporting on heat-related injury and illness in the setting of the ICU. Study Selection: English-language systematic reviews, narrative reviews, meta-analyses, randomized clinical trials, and observational studies were prioritized for review. Bibliographies from retrieved articles were scanned for articles that may have been missed. Data Extraction: Data regarding study methodology, patient population, management strategy, and clinical outcomes were qualitatively assessed. Data Synthesis: Several risk factors and prognostic indicators for patients diagnosed with heat-related illness and injury have been identified and reported in the literature. Effective management of these patients has included various cooling methods and fluid replenishment. Drug therapy is not effective. Multiple organ dysfunction, neurologic injury, and disseminated intravascular coagulation are common complications of heat stroke and must be managed accordingly. Burn injury from contact with hot surfaces or pavement can occur, requiring careful evaluation and possible excision and grafting in severe cases. Conclusions: The prevalence of heat-related illness and injury is increasing, and rapid initiation of appropriate therapies is necessary to optimize outcomes. Additional research is needed to identify effective methods and strategies to achieve rapid cooling, the role of immunomodulators and anticoagulant medications, the use of biomarkers to identify organ failure, and the role of artificial intelligence and precision medicine.

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Section: Clinical Managementmentioning

confidence: 99%

Management of Heat-Related Illness and Injury in the ICU: A Concise Definitive Review

Barletta,

Palmieri,

Toomey

et al. 2024

Critical Care Medicine

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“…Laboratory studies are justifiably constrained by upper limits of permissible hyperthermia, to protect the health of the research volunteers. This limits the applicability of these studies to EHS patients, as the thermoregulatory response differs with the thermal gradient and the degree of hyperthermia (6). McDermott observed that the thermoregulatory response of an EHS patient is expected to be very different from a volunteer whose T re reaches 40°C and "higher initial temperatures normally result in faster cooling rates" (9).…”

Section: Casementioning

confidence: 99%

“…While utilizing CWI with circulated ice water, or even tarp-assisted cooling, would be ideal, in many environments it is not an option. Delays in cooling, rather than simply the cooling method itself, may contribute to adverse outcomes (4,6).…”

Section: Casementioning

confidence: 99%

“…At Fort Moore, GA (formerly Fort Benning) Army Heat Center staff provide training and education on the prevention, recognition, and response to a suspected heat illness patient (11,12). Over the past 20+ years the practice of “ice sheet cooling” (ISC), consisting of bed linens soaked in ice water then applied to the patient, has gained widespread acceptance in military medicine, and this method has been shown to provide acceptable cooling in a cohort of EHS patients (6,13,14). In the Army initial entry training environment, drill sergeants and other nonmedical personnel often function as the first responders.…”

Section: Introductionmentioning

confidence: 99%

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Ice Sheet Cooling in the Field Reduces Morbidity in Exertional Heat Stroke

Willcox,

Rhodehouse,

DeGroot

2024

Curr Sports Med Rep

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“…No definitive lower limit to the cooling rate has been determined based on clinical outcomes. The cooling rate of 0.15°C•min −1 is based on limited field evidence that does not include clinical outcomes and other cooling strategies with lower cooling rates have equally acceptable clinical outcomes (3,4).…”

mentioning

confidence: 99%