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Heat Stroke

A Review of Cooling Methods


The prognosis of heat stroke in patients is directly related to the degree of hyperthermia and its duration. Therefore, the most important feature in the treatment of heat stroke is rapid cooling. Several cooling methods have been presented in the literature including immersion in water at different temperatures, evaporative cooling, ice pack application, pharmacological treatment and invasive techniques. This article describes the various cooling techniques in terms of efficacy, availability, adverse effects and mortality rate. Data suggest that cooling should be initiated immediately at time of collapse and should be based on feasible field measures including ice or tepid water (1–16°C), which are readily available. In the emergency department, management should be matched to the patient’s age and medical background and include immersion in ice water (1–5°C) or evaporative cooling.

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No sources of funding were used to assist in the preparation of this review. The authors have no conflicts of interest that are directly relevant to the content of this review.

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Correspondence to Yoram Epstein.

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Hadad, E., Rav-Acha, M., Heled, Y. et al. Heat Stroke. Sports Med 34, 501–511 (2004).

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  • Cool Rate
  • Water Immersion
  • Dantrolene
  • Core Body Temperature
  • Peritoneal Lavage