From the Guidelines
Ice packs should be placed in the axillae and groin to help lower a patient's fever. This method of cooling is recommended as it allows for efficient heat transfer and has been suggested in guidelines for managing hyperthermia 1. The axillae and groin areas are ideal locations for ice pack placement as they have a high concentration of blood vessels close to the skin's surface, enabling effective cooling of the blood.
- When applying ice packs, it is essential to wrap them in a thin cloth to prevent skin damage and limit application to 15-20 minutes at a time with breaks in between.
- It is also crucial to monitor the patient's temperature regularly and ensure they remain comfortable.
- If the patient begins shivering, remove the ice packs immediately as shivering can actually increase body temperature.
- Cooling with ice packs should be stopped once the patient's temperature drops below 38.5°C, as indicated in the guidelines for managing hyperthermia 1.
- Additionally, this cooling method should be used as a supportive measure alongside appropriate fever-reducing medications and medical attention should be sought for very high or persistent fevers.
From the Research
Placement of Ice Packs to Lower Fever
To help lower a patient's fever, ice packs can be placed in various locations. The following are some options:
- Groins: Ice packs can be applied in the groins to help cool the body, as shown in a study on inducing and maintaining therapeutic hypothermia after cardiac arrest 2.
- Axillae: Applying ice packs in the axillae (armpits) can also help lower body temperature, as demonstrated in the same study 2.
- Neck: The neck is another location where ice packs can be applied to cool the body, as seen in a study on inducing local mild hypothermia by cooling the head and neck 3.
- Ankle and thigh: Ice packs can be applied to the ankle and thigh to reduce skin temperature, as shown in a study on the effects of repeated ice pack application 4.
- Surface of casts: Ice packs can also be applied to the surface of synthetic or plaster casts to lower skin temperature, as demonstrated in a study on the effectiveness of ice packs in reducing skin temperature under casts 5.
Considerations for Ice Pack Application
When applying ice packs to lower fever, it's essential to consider the following:
- Duration of application: The duration of ice pack application can vary, but it's generally recommended to apply ice packs for 20-40 minutes, as seen in studies on repeated ice pack application 4 and inducing and maintaining therapeutic hypothermia after cardiac arrest 2.
- Temperature monitoring: It's crucial to monitor the patient's temperature closely to avoid hypothermia, as shown in a study on the comparison of multidose ibuprofen and acetaminophen therapy in febrile children 6.
- Rewarming: After ice pack application, the patient should be allowed to rewarm slowly to avoid rebound hyperthermia, as demonstrated in a study on inducing and maintaining therapeutic hypothermia after cardiac arrest 2.