Using Esophageal Temperature Management to Treat Severe Heat Stroke: A Case Report.
Katherine Riley Martin, Melissa Naiman, Maurice Espinoza
PMID 31842028WHAT IT FOUND
A firefighter with severe heat stroke reached 37.6°C within 30 minutes after an esophageal cooling device was placed when ice packs, water blankets, and cold intravenous fluids had not reached target.
He had no residual deficits at 30-day follow-up, but this is one case.
Key findings
01The patient's temperature remained 38.1°C despite ice packs, water blankets, and cold intravenous fluids; within 30 minutes of esophageal cooling device placement it reached 37.6°C.
02After reaching 37.6°C, the patient developed low platelets, liver enzyme elevation, and muscle breakdown over the next 3 days, then recovered kidney, liver, and muscle markers.
03By day 5 the device was removed and the patient was extubated, and at 30-day follow-up no residual deficits were found.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
This is a case report of one patient, so it cannot show what would have happened without the esophageal cooling device. The patient received ice packs, water blankets, cold intravenous fluids, sedation, antibiotics, antivirals, antiepileptic treatment, and rehabilitation at the same time, so the contribution of any single component cannot be separated. The authors' statements that the technique was novel and nursing-driven are interpretations in the Discussion and Conclusions, not tested findings. Follow-up was reported at 30 days, so longer-term outcomes are not described.
The easy way to misread this
Do not read this as evidence that esophageal cooling treats heat stroke. The patient received ice packs, water blankets, cold intravenous fluids, sedation, antibiotics, antivirals, antiepileptic treatment, and rehabilitation, and this report has no comparison group.