Clinical Scenario: Exertional heat stroke (EHS) is a medical emergency characterized by body core temperatures >40.5°C and central nervous system dysfunction. An EHS diagnosis should be immediately followed by cold-water immersion (CWI). Ideally, EHS victims cool at a rate >0.15°C/min until their temperature reaches 38.9°C. While generally accepted, these EHS treatment recommendations often stem from research that examined only males. Since gender differences exist in anthropomorphics (eg, body surface area, lean body mass) and anthropomorphics impact CWI cooling rates, it is possible that CWI cooling rates may differ between genders. Clinical Question: Do CWI rectal temperature (T rec) cooling rates differ between hyperthermic males and females? Summary of Findings: The average T rec cooling rate across all examined studies for males and females was 0.18 (0.05) and 0.24 (0.03)°C/min, respectively. Hyperthermic females cooled ∼33% faster than males. Clinical Bottom Line: Hyperthermic females cooled faster than males, most likely because of higher body surface area to mass ratios and less lean body mass. Regardless of gender, CWI is highly effective at lowering T rec. Clinicians must be able to treat all EHS victims, regardless of gender, with CWI, given its high survival rate when implemented appropriately. Strength of Recommendation: Moderate evidence (2 level 3 studies) suggests that females cool faster than males when treated with CWI following severe hyperthermia. Despite gender differences, cooling rates exceeded cooling rate recommendations for EHS victims (ie, 0.15°C/min).
Kayla E. Boehm and Kevin C. Miller
Kayla E. Boehm, Blaine C. Long, Mitchell T. Millar and Kevin C. Miller
Effectiveness of Kinesiology Tex Tape (KTT) is conflicting, with some clinicians supporting and others refuting its effects. There is limited information on the psychological effects of KTT or whether its increased use has been influenced by professional athletes. The purpose of this study was to assess the physiological, psychological, and use of KTT. A descriptive survey on the use of KTT was performed with athletic trainers and other health care providers. Many reported that KTT benefited patients physiologically and psychologically. Those who thought KTT provided a physiological benefit indicated that they use it. Many indicated KTT benefited patients psychologically, without impacting them physiologically. In addition, clinicians indicated KTT use has been influenced by professional athletes.