Novel method of cold water immersion for heat stroke

The specific use of body bags/cadaver pouches for this purpose is also an old policy (since at least 2005 based on my experience) in marine SAR, so I echo your wife's sentiments.

I imagine some of the importance of documenting ED techniques like this is because in the prehospital setting many of the interventions that nonphysicians are allowed to provide are governed by standing protocols. For regional medical directors to endorse such interventions by third-parties, they require the techniques be well-documented before they are formally adopted.

For anyone else wondering, "ED" in this instance refers to "Emergency Department".

Not sure how effective cold water immersion would be at treating the other kind of ED...

Yeah I was taught effectively this long ago in scouts too.

If they have a temp of 104, start cooling immediately and call 911. No need to get fancy, although if you can only cool in a couple spots, under arms/on neck/head/chest is better than the extremities or something.

The opposite, treating hypothermia, is much more technically specific in how to treat without harming the person more. Look it up if you will be in very cold wet places for extended periods. But if you don't know what to do, call 911 and ask them.

Great question. Short answer from the Red Cross and Mayo Clinic: (1) Contact 911 first (2) Begin immediate cooling by any method including removing them from the hot environment, removing their clothing, and applying cold water immersion or cold water on skin with fanning and (3) transfer to hospital while continuing to cool

Details: The American Red Cross in their current guidelines available at https://cpr.heart.org/en/resuscitation-science/first-aid-gui... and https://doi.org/10.1161/CIR.0000000000000900 advise that “For adults and children with exertional hyperthermia or heat stroke, first aid providers should move the individual from the hot environment, remove excess clothing, limit exertion, and activate emergency services.

For adults with exertional hyperthermia or heatstroke, it is reasonable to initiate immediate active cooling by using whole-body (neck down) cool- to cold-water immersion techniques (1°C–26°C [33.8°F–78.8°F]), when safe, until a core body temperature of <39°C (102.2°F) is reached or neurological symptoms resolve.

For children with exertional hyperthermia or heatstroke, it may be reasonable to initiate immediate active cooling by using whole-body (neck down) cool- to cold-water immersion techniques (1°C–26°C [33.8°F–78.8°F]), when safe, until a core body temperature of <39°C (102.2°F) is reached or neurological symptoms resolve.”

From this we can conclude you might reasonably cool those suffering from heat stroke yourself within the generally-accepted first aid standards or scope of practice (in fact, the Red Cross/AHA use the language should for their active cooling recommendations in some summaries). You would want to have a way of checking the patient’s temperature to cease cooling interventions when it reaches 102.2°F (other sources advise stopping if the patient begins to shiver). This recommendation was added in 2020, the most recent guideline update.

The fancy interventions that paramedics and advanced prehospital clinicians can administer include IV fluid replacement, anticonvulsants, and intubation (cf. https://emcrit.org/ibcc/hyperthermia/) and the ambulance has a/c and potentially other cooling devices. Also there is a possibility for cardiac failure https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8843991/ so all providers should be prepared to initiate CPR and EMS has tools for cardiac monitoring and support/resuscitation.

Yeah the idea of being in a body bag full of ice water sounds pretty uncomfortable. If they were doing it to me I would ask to have my hands and feet put in something like boxing gloves to keep them warm. And my nads too, now that I think of it. Yeesh.

A fever is very different, and trying to cool people down should NOT be the first reaction.

There are off-the-shelf cooling vests you can buy. They're basically ice packs and matching pockets to put them in:

https://texascoolvest.com/ https://www.coolingvest.com/

You want a furry cooling vest https://www.thedailybeast.com/how-a-cooling-vest-invented-by...

There's been some interesting stuff about cooling the body for exercise performance, and they've found that the soles of the feet, the palms of the hands, and the cheeks are the locations that are most efficient in applying the cooling.

So perhaps just "cool boots" might be enough.

A coworker of mine spent a lot of time maintaining computers in warehouses in the US South and picked up a jacket with basically PC-fans built in, it had sleeves and some of the airflow was down the sleeves. We mostly joked about needing to overclock our field technicians...

Dirt bike riders/motorcyclists have been pouring water over their clothes/suits and then riding for generations.

Works great to cool down well below ambient air temp as long as humidity isn't super high.

surgically implanted tubes sounds fun. We could run them though your entire body. Like water holes in cpu's Or perhaps one could repurpose existing tubing.

Speaking of, this could be useful at Burning Man if it's a scorcher.

Nope, it's more mundane than that. It's novel for non-exertion heat stroke. Seems to me like a distinction without a difference. How the body got into an overheated seems mostly irrelevant as to whether an ice bath in a tub vs a bag. But they acknowledge this technique is used in exertional heat stroke.

Yes, this is described in the abstract.