Thermometers

[zmedic]

I think it would depend on what is already in place and (obviously) protocols. If you were working a marathon in August, they brought a guy to the first aid tent who looks like he is suffering heat stroke, and has altered mental status. Now I tell you his temperature is 107 rectally, what do you do? I'd say if there was an immersion tub ready to go, cooling right now takes priority over transport. If it's going to take 15 minutes to set it up, I'd rather someone start basic cooling methods (wetting and fanning, removing clothes, A/C) and transport.

This is one of the few scenarios where the temp really matters. You tell me someone has a core temp of 101, I say start basic cooling and get moving. You tell me it's 106, I say they have to get cooled RIGHT NOW.

 

[MonkeyArrow]

Check out this website. Also the NATA will have new guidelines coming out soon.

http://ksi.uconn.edu

I'm pretty sure I already posted the video about why it was important to COOL first, transport second. In some states, it is now required that high schools have a cold tub ready in case of exertional heat stroke because it is critical to cool ASAP. Full body immersion is the BEST cooling mechanism. You can't do that in the back of an ambulance..

Also, realize that in an active individual, there are only two accurate mechanisms of reading core body temperature. Use of a ingestible thermometers or a rectal thermometer. Using an oral thermometer is not "good enough."

You're right. I can't immerse someone in a tub of ice water in the back of my bus. But I can guarantee that 99.9% of the hyperthermia calls I run, there won't be a tub of ice water waiting for me to use on scene, especially in the SAR context that we were talking about earlier. However, I can guarantee you that one way or another, there will be a tub of ice water/chilled saline/ice packs made available for the pt's use at the hospital.