A 55 yo male with unknown past medical history is found by EMS outside on a hot summer day with AMS and brought to your ED. Skin is notably dry and hot. Core temperature is found to be 105F. What is the best way to cool him down while you perform your resuscitation?

A. Cold thoracic and peritoneal lavage

B. Cold normal saline IV infusion

C. Spritz him with room temperature water while fans blow on him

D. Spritz him with cold water while fans blow on him

C. A room temperature water mist with fans blowing to promote rapid evaporative heat loss is your best option (assuming your ED doesn’t have cold water immersion tanks). Cold water mists actually promote shivering and peripheral vasoconstriction, both of which will counteract your efforts.

Gauer, R., Meyers, B. (2019, April 15). Heat-Related Illnesses. American Family Physician, 99(8):482-489.Retrieved from: http://www.afp-digital.org/afp/april_15_2019/MobilePagedArticle.action?a...

For a quick review, please refer to our older post: http://emdaily.cooperhealth.org/content/heat-stroke