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Cooling methods for paediatric heat-induced illnesses
  1. Dried Jamal1,
  2. Ibtihal Abdelgadir1,
  3. Colin V E Powell1,2
  1. 1 Pediatric Emergency, Sidra Medical and Research Center, Doha, Qatar
  2. 2 Division of Population Medicine, Cardiff University School of Medicine, Cardiff, UK
  1. Correspondence to Professor Colin V E Powell, Emergency Medicine, Sidra Medical and Research Center, Doha, Qatar; PowellC7{at}

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Clinical bottom line

  • Initiate rapid cooling techniques (aiming for a rate of 0.2°C/min) within the first hour to minimise complications in exercise-induced heat-related illness (grade A).

  • Ice water and cold water immersion cools twice as fast as passive recovery (grade B); however, ice water immersion in a ventilated monitored patient remains technically challenging to perform.

  • There is insufficient evidence to support the use of one different cooling method over another in the paediatric population (grade D).

Clinical scenario

A 5-year-old male presented to the Paediatric Emergency Department (PED) after being accidentally left in a locked car for 3 hours, where the external temperature was 49 °C. His mother realised that the child was missing; she went to the car where she found him unresponsive. The ambulance services were called. The child was noted to be unresponsive with Glasgow Coma Scale score of 3 with a core rectal temperature of 40.6 °C. The patient’s airway was secured with a Guedel support during the transfer then he was intubated and ventilated in PED. His circulation was managed appropriately with a bolus of 20 mL/kg of normal saline and maintenance fluids initiated. Passive cooling was started during the transfer …

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  • Correction notice This paper has been updated since it was published online. The second author's surname was spelt incorrectly.

  • Contributors The concept of the paper was initiated by DJ and CVEP. DJ and IA completed the initial literature search and data extraction. DJ wrote the original manuscript which was then developed and edited by CVEP and IA.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Not required.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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