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Toxicology
Ice-water immersion wins for drug hyperthermia
Comparison of cooling methods for drug-induced hyperthermia in a pre-hospital and emergency department setting: a systematic review
Clinical Toxicology · 2026-10-07 · Added 9 October 2026
A systematic review of 71 studies (1,932 patients) comparing cooling methods for drug-induced (and exercise-induced) hyperthermia found ice-water and cold-water immersion fastest at ~0.16–0.17 °C/min and clearly superior to passive cooling.
- Study type
- Systematic review
- Design
- Systematic review with meta-analysis (GRADE)
- Participants
- 71 studies, 1,932 patients, 12 cooling modalities
- Main finding
- Ice-water immersion cooled at 0.169 ± 0.027 °C/min and cold-water immersion at 0.162 ± 0.037 °C/min — the fastest modalities; ice-water-soaked sheets/towels 0.121 ± 0.030 °C/min; meta-analysis confirmed immersion beats passive cooling
- Caveat
- Many included studies cover exercise-induced rather than drug-induced hyperthermia, and practicality varies by setting
- Bottom line
- Supports current practice
Why it matters in Australia (High relevance). Stimulant toxicity and heat illness with hyperthermia are everyday presentations across Australia, and aggressive active cooling is achievable prehospital — the ranking of methods is directly actionable.
Learning goal
Weigh the practicality of immersion cooling for drug-induced hyperthermia in my prehospital practice.
More
- Topic: Toxicology
- Daily scan: 9 October 2026
- Podcast: Paramedic Papers Daily, 9 October 2026
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