No abstract

Critically ill patients who have sustained a severe cerebral insult will be actively cooled should they develop an elevated body core temperature. Patients who require therapeutic hypothermia for neuroprotection may require the same cooling strategies. A literature review suggested limited evidence to support cooling strategies currently used within one intensive care unit. An experimental approach was used to examine the effects of paracetamol and four external cooling strategies on patients with severe cerebral insult It is suggested that paracetamol is effective in reducing body core temperature and that fans may not. However, data obtained from the study of the four external cooling strategies were inconclusive.

Simulation training is a beneficial part of medical education for APPs and should be considered in addition to traditional didactics and clinical training. Further research is needed to determine whether simulation education of APPs results in improved treatment times and outcomes of acute stroke patients.

A review of the literature was undertaken to determine the existence of any evidence to support cooling strategies used in the ICU. The focus of the review was to examine previous findings on the specific problems of cooling patients with severe cerebral insult. Cooling methods that use external physical cooling strategies as well as the effects of antipyretics and vasoactive drugs were examined. Overall, it would appear that conclusions for practice remain unclear. The findings led to the implementation of a pilot study, the findings of which will be discussed in Part 2.