4.0 Article

Tarp-Assisted Cooling for Exertional Heat Stroke Treatment in Wildland Firefighting

Journal

WILDERNESS & ENVIRONMENTAL MEDICINE
Volume 34, Issue 4, Pages 490-497

Publisher

ELSEVIER SCIENCE INC
DOI: 10.1016/j.wem.2023.08.002

Keywords

heat illness; hyperthermia; thermoregulation; modality; cold; immersion

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This study compared the difference in core temperature reduction rate between tarp-assisted cooling and the current standard care in a wilderness setting. The results showed that tarp-assisted cooling did not provide a faster core temperature reduction rate compared to the current standard care.
Introduction: Exertional heat stroke is a life-threatening emergency necessitating immediate treatment with rapid body cooling. A field-expedient alternative may be tarp-assisted cooling, requiring only water and a tarp. The objective of this study was to compare core temperature (T-c) cooling rates of tarp-assisted cooling using the limited resources available to a wildland firefighter and the current standard care provided in wilderness settings.Methods: This cross-over, randomized control trial of 17 healthy individuals consisted of exercise in a 42 +/- 1 degrees C, 32 +/- 4% relative humidity environment while wearing wildland firefighter attire, followed by cooling. Body cooling consisted of either pouring 11 L of 25 +/- 1 degrees C water over the torso while lying supine on a tarp configured to hold water close to the individual (Tarp) or dousing the water on the participant followed by lying supine with a light breeze, current standard care in the wilderness (Current Care). Cooling occurred until T-c reached 38 degrees C.Results: Participants walked until a similar T-c was achieved in Tarp (39.59 +/- 0.04 degrees C) and Current Care (39.55 +/- 0.22 degrees C; P=0.36). Core temperature cooling rate was not different between Tarp (0.076 +/- 0.042 degrees Cmin(-1)) and Current Care (0.088 +/- 0.046 degrees Cmin(-1); P=0.41).Conclusions: In hyperthermic individuals, Tarp did not provide a faster cooling rate compared to the current exertional heat stroke care provided in the wilderness, and both provided a slower cooling rate than that provided by the traditional method of cold water immersion (>0.20 degrees Cmin(-1)) to treat exertional heat stroke patients.

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