Validity of Core Temperature Measurements at 3 Rectal Depths During Rest, Exercise, Cold-Water Immersion, and Recovery

Miller, Kevin; Hughes, Lexie E.; Long, Blaine; Adams, William M.; Casa, Douglas J.

doi:10.4085/1062-6050-52.2.10

Cited by 45 publications

(35 citation statements)

References 29 publications

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“…Core temperature, instead of body surface temperature, should be measured on site because of the potential dissociation between the two in critically ill patients. Rectal temperature should be preferred; it can be measured by inserting a flexible rectal thermometer to a depth of at least 15 cm [55]. If core temperature (rectal temperature) cannot be measured on site, surface temperature (axillary or tympanic temperature) can be measured as a reference.…”

Section: On-site Emergency Treatmentsmentioning

confidence: 99%

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Expert consensus on the diagnosis and treatment of heat stroke in China

et al. 2020

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Heat stroke (HS) is a fatal disease caused by thermal damage in the body, and it has a very high mortality rate. In 2015, the People's Liberation Army Professional Committee of Critical Care Medicine published the first expert consensus on HS in China, Expert consensus on standardized diagnosis and treatment for heat stroke. With an increased understanding of HS and new issues that emerged during the HS treatment in China in recent years, the 2015 consensus no longer meet the requirements for HS prevention and treatment. It is necessary to update the consensus to include the latest research evidence and establish a new consensus that has broader coverage, is more practical and is more in line with China's national conditions. This new expert consensus includes new concept of HS, recommendations for laboratory tests and auxiliary examinations, new understanding of diagnosis and differential diagnosis, On-site emergency treatment and In-hospital treatment, translocation of HS patients and prevention of HS.

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Section: On-site Emergency Treatmentsmentioning

confidence: 99%

“…Core temperature should be monitored continuously or measured at least once every 10 min for HS patients before the disease condition is stabilized. When measuring core temperature, the damage to the rectum and the adjacent tissue should be avoided [55,58].…”

Section: Continuous Monitoring Of Body Temperaturementioning

confidence: 99%

Expert consensus on the diagnosis and treatment of heat stroke in China

et al. 2020

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“…23 Each participant donned a heart-rate monitor (Polar Electro Inc, Lake Success, NY) and self-inserted a thermistor (model 401; Advanced Industrial Systems, Prospect, KY) 15 cm past the anal sphincter. 24 Then, he put on PADS. Briefly, PADS consisted of shoes; socks; undergarments; athletic shorts; three-quarter-length pants with hip, knee, tailbone, and thigh padding; a T-shirt; shoulder pads; a mesh jersey; and a helmet.…”

Section: Methodsmentioning

confidence: 99%

Cooling Rates of Hyperthermic Humans Wearing American Football Uniforms When Cold-Water Immersion Is Delayed

Miller

Mango

Katt

2018

Journal of Athletic Training

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Context Treatment delays can be contributing factors in the deaths of American football athletes from exertional heat stroke. Ideally, clinicians begin cold-water immersion (CWI) to reduce rectal temperature (Trec) to <38.9°C within 30 minutes of collapse. If delays occur, experts recommend Trec cooling rates that exceed 0.15°C/min. Whether treatment delays affect CWI cooling rates or perceptual variables when football uniforms are worn is unknown. Objective To answer 3 questions: (1) Does wearing a football uniform and delaying CWI by 5 minutes or 30 minutes affect Trec cooling rates? (2) Do Trec cooling rates exceed 0.15°C/min when treatment delays have occurred and individuals wear football uniforms during CWI? (3) How do treatment delays affect thermal sensation and Environmental Symptoms Questionnaire responses? Design Crossover study. Setting Laboratory. Patients or Other Participants Ten physically active men (age = 22 ± 2 y, height = 183.0 ± 6.9 cm, mass = 78.9 ± 6.0 kg). Intervention(s) On 2 days, participants wore American football uniforms and exercised in the heat until Trec was 39.75°C. Then they sat in the heat, with equipment on, for either 5 or 30 minutes before undergoing CWI (10.6°C ± 0.1°C) until Trec reached 37.75°C. Main Outcome Measure(s) Rectal temperature and CWI duration were used to calculate cooling rates. Thermal sensation was measured pre-exercise, postexercise, postdelay, and post-CWI. Responses to the Environmental Symptoms Questionnaire were obtained pre-exercise, postdelay, and post-CWI. Results The Trec cooling rates exceeded recommendations and were unaffected by treatment delays (5-minute delay = 0.20°C/min ± 0.07°C/min, 30-minute delay = 0.19°C/min ± 0.05°C/min; P = .4). Thermal sensation differed between conditions only postdelay (5-minute delay = 6.5 ± 0.6, 30-minute delay = 5.5 ± 0.7; P < .05). Environmental Symptoms Questionnaire responses differed between conditions only postdelay (5-minute delay = 27 ± 15, 30-minute delay = 16 ± 12; P < .05). Conclusions Treatment delays and football equipment did not impair CWI's effectiveness. Because participants felt cooler and better after the 30-minute delay despite still having elevated Trec, clinicians should use objective measurements (eg, Trec) to guide their decision making for patients with possible exertional heat stroke.

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“…22 Body surface area was also estimated. 24 Each participant donned a heart-rate monitor, selfinserted a thermistor (model 401; Advanced Industrial Systems, Prospect, KY) 15 cm past the anal sphincter, 25 and put on PADS. For a complete description of the PADS worn, we direct the reader to previous work from our laboratory.…”

Section: Methodsmentioning

confidence: 99%

Temperate-Water Immersion as a Treatment for Hyperthermic Humans Wearing American Football Uniforms

Miller

Truxton

Long

2017

Journal of Athletic Training

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Context: Cold-water immersion (CWI; 108C) can effectively reduce body core temperature even if a hyperthermic human is wearing a full American football uniform (PADS) during treatment. Temperate-water immersion (TWI; 218C) may be an effective alternative to CWI if resources for the latter (eg, ice) are unavailable.Objective: To measure rectal temperature (T rec ) cooling rates, thermal sensation, and Environmental Symptoms Questionnaire (ESQ) scores of participants wearing PADS or shorts, undergarments, and socks (NO pads ) before, during, and after TWI.Design: Crossover study. Setting: Laboratory.Patients or Other Participants: Thirteen physically active, unacclimatized men (age ¼ 22 6 2 years, height ¼ 182.3 6 5.2 cm, mass ¼ 82.5 6 13.4 kg, body fat ¼ 10% 6 4%, body surface area ¼ 2.04 6 0.16 m 2 ). Intervention(s): Participants exercised in the heat (408C, 50% relative humidity) on 2 days while wearing PADS until T rec reached 39.58C. Participants then underwent TWI while wearing either NO pads or PADS until T rec reached 388C. Thermal sensation and ESQ responses were collected at various times before and after exercise.Main Outcome Measure(s): Temperate-water immersion duration (minutes), T rec cooling rates (8C/min), thermal sensation, and ESQ scores.Results: Participants had similar exercise times (NO pads ¼ 38.1 6 8.1 minutes, PADS ¼ 38.1 6 8.5 minutes), hypohydration levels (NO pads ¼ 1.1% 6 0.2%, PADS ¼ 1.2% 6 0.2%), and thermal sensation ratings (NO pads ¼ 7.1 6 0.4, PADS ¼ 7.3 6 0.4) before TWI. Rectal temperature cooling rates were similar between conditions (NO pads ¼ 0.128C/min 6 0.058C/min, PADS ¼ 0.138C/min 6 0.058C/min; t 12 ¼ 0.82, P ¼ .79). Thermal sensation and ESQ scores were unremarkable between conditions over time.Conclusions: Temperate-water immersion produced acceptable (ie, .0.088C/min), though not ideal, cooling rates regardless of whether PADS or NO pads were worn. If a football uniform is difficult to remove or the patient is noncompliant, clinicians should begin water-immersion treatment with the athlete fully equipped. Clinicians should strive to use CWI to treat severe hyperthermia, but when CWI is not feasible, TWI should be the next treatment option because its cooling rate was higher than the rates of other common modalities (eg, ice packs, fanning).Key Words: Environmental Symptoms Questionnaire, exertional heat stroke, rectal temperature, thermal sensation Key PointsTemperate-water immersion produced acceptable, though not ideal, cooling rates. Wearing American football uniforms did not negatively affect rectal temperature cooling rate, thermal sensation, or Environmental Symptoms Questionnaire score. If cold-water immersion is not feasible, temperate-water immersion should be used for exertional heatstroke.

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Validity of Core Temperature Measurements at 3 Rectal Depths During Rest, Exercise, Cold-Water Immersion, and Recovery

Cited by 45 publications

References 29 publications

Expert consensus on the diagnosis and treatment of heat stroke in China

Expert consensus on the diagnosis and treatment of heat stroke in China

Cooling Rates of Hyperthermic Humans Wearing American Football Uniforms When Cold-Water Immersion Is Delayed

Temperate-Water Immersion as a Treatment for Hyperthermic Humans Wearing American Football Uniforms

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