The American journal of emergency medicine · 2025
Using ice packing and the polar life pod to treat severe hyperthermia.
СтатьяПоддержка исследования: вне правительства СШАНазвание и аннотация: Перевод в очереди
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Miller Kevin C, Beck Jessie L, Valadez Sofia G, Koldenhoven Rachel M, Uriegas Nancy A, Lally Erin M
Аннотация
INTRODUCTION: Cold water immersion (CWI) is the fastest method of reducing body temperature of exertional heatstroke (EHS) patients. Treatment delays and/or an inability to quickly cool EHS patients with CWI before or while enroute to hospitals are common contributors to EHS morbidity and mortality. CWI in ambulances and emergency departments (ED) is challenging since they often lack CWI equipment (e.g., tubs). Recently, clinicians demonstrated excellent EHS patient outcomes using CWI with body bags (BAGS). However, using BAGS with CWI in ED creates other challenges (e.g., medical staff slipping, drainage). Ice packing with BAGS may quickly reduce body temperature and resolve these issues. We measured rectal temperature (TREC) cooling rates with three ice masses and no added water in the Polar Life Pod (PLP), a body-bag-like device.
METHODS: Twelve subjects (8 males, 4 females; age:22 ± 3y; mass:71.9 ± 10.6 kg; ht.:170.2 ± 7.3 cm) exercised in the heat (wet bulb globe temperature = ∼27 °C) until TREC was ≥39.75 °C. They laid in PLP while ∼9 kg (SMALL), ∼27 kg (MEDIUM), or ∼ 53 kg (LARGE) of nugget ice was poured into PLP. Cooling stopped when TREC was 38.25 °C.
RESULTS: TREC cooling rates increased as ice mass increased (SMALL:0.15 ± 0.05 °C/min; MEDIUM:0.19 ± 0.07 °C/min; LARGE:0.27 ± 0.10 °C/min, P < 0.001). Minimal water was created from ice melting (SMALL: 3.8 ± 1.1 L; MEDIUM: 5.3 ± 2.1 L; LARGE: 4.9 ± 2.2 L, P = 0.07).
CONCLUSIONS: Ice packing in the PLP quickly reduced TREC and resolved many of the challenges of treating EHS in ED and ambulances. The PLP portability, small space footprint, and effectiveness suggest it can be implemented while enroute to ED, potentially reducing the morbidity and mortality caused by lengthy treatment delays.
METHODS: Twelve subjects (8 males, 4 females; age:22 ± 3y; mass:71.9 ± 10.6 kg; ht.:170.2 ± 7.3 cm) exercised in the heat (wet bulb globe temperature = ∼27 °C) until TREC was ≥39.75 °C. They laid in PLP while ∼9 kg (SMALL), ∼27 kg (MEDIUM), or ∼ 53 kg (LARGE) of nugget ice was poured into PLP. Cooling stopped when TREC was 38.25 °C.
RESULTS: TREC cooling rates increased as ice mass increased (SMALL:0.15 ± 0.05 °C/min; MEDIUM:0.19 ± 0.07 °C/min; LARGE:0.27 ± 0.10 °C/min, P < 0.001). Minimal water was created from ice melting (SMALL: 3.8 ± 1.1 L; MEDIUM: 5.3 ± 2.1 L; LARGE: 4.9 ± 2.2 L, P = 0.07).
CONCLUSIONS: Ice packing in the PLP quickly reduced TREC and resolved many of the challenges of treating EHS in ED and ambulances. The PLP portability, small space footprint, and effectiveness suggest it can be implemented while enroute to ED, potentially reducing the morbidity and mortality caused by lengthy treatment delays.