Cold Water Immersion: The Gold Standard for Exertional Heatstroke Treatment

Douglas J. Casa; Brendon P. McDermott; Elaine C. Lee; Susan W. Yeargin; Lawrence E. Armstrong; Carl M. Maresh


Exerc Sport Sci Rev. 2007;35(3):141-149. 

In This Article


The key element in maximizing the chances of surviving EHS is rapidly decreasing the elevated core body temperature. Many methods exist to cool the body, but the evidence currently available provides strong support that cold water, preferably immersion, or if lack of equipment or staff warrant, a continual dousing of cold water (as would occur in a cold shower or with ice water-soaked towels), provides the fastest cooling rate. We have refuted the repeated criticisms of using CWI to treat EHS. The bottom line is that the powerful cooling capacity provided by cold water offers the best opportunity for an otherwise healthy athlete who experiences EHS to survive the incident and experience no lasting consequences.

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