From the Guidelines
Cold compresses are a reasonable form of active cooling for hyperthermia, particularly when used in conjunction with other methods such as cool liquids and removal of excess clothing, as recommended by the 2024 American Heart Association and American Red Cross guidelines for first aid 1. When managing hyperthermia, it is essential to prioritize immediate cooling and removal from the hot environment. The guidelines suggest that for adults and children with heatstroke, active cooling using whole-body cool- to cold-water immersion for 15 minutes or until neurological symptoms resolve is a reasonable approach 1.
- Other forms of active cooling, including commercial ice packs, cold showers, ice sheets and towels, cooling vests and jackets, and evaporative, fanning, or a combination of techniques, are also recommended when water immersion is not available 1.
- The target core temperature to cool until is 39° C (102.2° F), and measuring core temperature during active cooling may be reasonable for trained first aid providers 1. Key considerations for using cold compresses include:
- Applying them to areas where blood vessels are close to the skin surface, such as the forehead, neck, armpits, or groin areas.
- Using cool, damp washcloths to help draw heat away from the body through conduction.
- Combining cold compresses with other cooling methods and removal of excess clothing for optimal effect. It is crucial to note that while cold compresses can provide temporary relief, they should be used as part of a comprehensive approach to managing hyperthermia, including removal from the hot environment, provision of cool liquids, and activation of emergency services if necessary, as outlined in the guidelines 1.
From the Research
Effectiveness of Cold Compresses in Reducing Hyperthermia
- There are no research papers provided that directly assess the effectiveness of cold compresses in reducing hyperthermia 2, 3, 4, 5, 6.
- The studies provided focus on the use of antipyretic medications such as paracetamol and ibuprofen in reducing fever, rather than physical cooling methods like cold compresses.
- One study suggests that physical cooling methods alone should never be used, and that antipyretic therapies should be used selectively 4.
- The evidence provided does not support the use of cold compresses as a method for reducing hyperthermia, as the studies focus on pharmacological interventions rather than physical cooling methods.
Alternative Methods for Reducing Fever
- The use of paracetamol and ibuprofen, either alone or in combination, has been shown to be effective in reducing fever in children and adults 2, 3, 5, 6.
- An alternating regimen of acetaminophen and ibuprofen has been shown to be more effective than monotherapy in lowering fever in infants and children 6.
- The combination of paracetamol and ibuprofen may be more effective than paracetamol alone in patients with bacterial fever 2.