What are pearls for the use of cooling in the treatment of hyperthermia?

Updated: Oct 14, 2020
  • Author: Erik D Schraga, MD; Chief Editor: Sage W Wiener, MD  more...
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Antipyretics are not effective in treating environmental hyperthermia.

Use intravenous fluids modestly in the setting of hypotension and hyperthermia to avoid worsening pulmonary edema. Cooling is the treatment of choice to cause peripheral vasoconstriction and reduce venous pooling.

Consider using benzodiazepines to reduce agitation and shivering during initial cooling and to treat hyperthermia due to sympathomimetic ingestion.

Coagulopathy is a common physiologic response to hyperthermia; be sure to monitor for disseminated intravascular coagulopathy (DIC).

Consider a trial of glucose in any patient with altered mental status.

Avoid rapid replacement of free water, as hyponatremia and cerebral edema may develop.

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