TY - JOUR
T1 - Can temperate-water immersion effectively reduce rectal temperature in Exertional heat stroke? A critically appraised topic
AU - Truxton, Tyler T.
AU - Miller, Kevin C.
N1 - Publisher Copyright:
© 2017 Human Kinetics, Inc.
PY - 2017/9/1
Y1 - 2017/9/1
N2 - Clinical Scenario: Exertional heat stroke (EHS) is a medical emergency which, if left untreated, can result in death. The standard of care for EHS patients includes confirmation of hyperthermia via rectal temperature (Trec) and then immediate cold-water immersion (CWI). While CWI is the fastest way to reduce Trec, it may be difficult to lower and maintain water bath temperature in the recommended ranges (1.7°C-15°C [35°F-59°F]) because of limited access to ice and/or the bath being exposed to high ambient temperatures for long periods of time. Determining if Trec cooling rates are acceptable (ie, > 0.08°C/min) when significantly hyperthermic humans are immersed in temperate water (ie, ≥ 20°C [68°F]) has applications for how EHS patients are treated in the field. Clinical Question: Are Trec cooling rates acceptable (≥0.08°C/min) when significantly hyperthermic humans are immersed in temperate water? Summary of Findings: Trec cooling rates of hyperthermic humans immersed in temperate water (≥20°C [68°F]) ranged from 0.06°C/min to 0.19°C/min. The average Trec cooling rate for all examined studies was 0.11±0.06°C/min. Clinical Bottom Line: Temperature water immersion (TWI) provides acceptable (ie, > 0.08°C/min) Trec cooling rates for hyperthermic humans post-exercise. However, CWI cooling rates are higher and should be used if feasible (eg, access to ice, shaded treatment areas). Strength of Recommendation: The majority of evidence (eg, Level 2 studies with PEDro scores ≥5) suggests TWI provides acceptable, though not ideal, Trec cooling. If possible, CWI should be used instead of TWI in EHS scenarios.
AB - Clinical Scenario: Exertional heat stroke (EHS) is a medical emergency which, if left untreated, can result in death. The standard of care for EHS patients includes confirmation of hyperthermia via rectal temperature (Trec) and then immediate cold-water immersion (CWI). While CWI is the fastest way to reduce Trec, it may be difficult to lower and maintain water bath temperature in the recommended ranges (1.7°C-15°C [35°F-59°F]) because of limited access to ice and/or the bath being exposed to high ambient temperatures for long periods of time. Determining if Trec cooling rates are acceptable (ie, > 0.08°C/min) when significantly hyperthermic humans are immersed in temperate water (ie, ≥ 20°C [68°F]) has applications for how EHS patients are treated in the field. Clinical Question: Are Trec cooling rates acceptable (≥0.08°C/min) when significantly hyperthermic humans are immersed in temperate water? Summary of Findings: Trec cooling rates of hyperthermic humans immersed in temperate water (≥20°C [68°F]) ranged from 0.06°C/min to 0.19°C/min. The average Trec cooling rate for all examined studies was 0.11±0.06°C/min. Clinical Bottom Line: Temperature water immersion (TWI) provides acceptable (ie, > 0.08°C/min) Trec cooling rates for hyperthermic humans post-exercise. However, CWI cooling rates are higher and should be used if feasible (eg, access to ice, shaded treatment areas). Strength of Recommendation: The majority of evidence (eg, Level 2 studies with PEDro scores ≥5) suggests TWI provides acceptable, though not ideal, Trec cooling. If possible, CWI should be used instead of TWI in EHS scenarios.
KW - Heat stroke
KW - Hyperthermia
KW - Treatment
UR - http://www.scopus.com/inward/record.url?scp=85032218847&partnerID=8YFLogxK
U2 - 10.1123/jsr.2015-0200
DO - 10.1123/jsr.2015-0200
M3 - Article
C2 - 27632869
AN - SCOPUS:85032218847
VL - 26
SP - 447
EP - 451
JO - Journal of Sport Rehabilitation
JF - Journal of Sport Rehabilitation
SN - 1056-6716
IS - 5
ER -