The 20-year-old healthy soccer player is brought to the emergency department after collapsing at the end of a summer soccer game. The patient is lethargic and confused about the event. Upon assessment, the nurse notes flushed, dry skin that is warm to the touch. The oral mucosa is dry, as well. Vitals are as follows: temperature 40.7°C, heart rate 122 bpm, respiratory rate 20, and blood pressure 116/64 mmHg. A rectal thermistor is inserted and aggressive cooling measures are instituted. After 30 minutes in the ice bath, the patient’s rectal temperature is 39.1°C and the ice is partially melted. Which action by the nurse is most important?

Question

The 20-year-old healthy soccer player is brought to the emergency department after collapsing at the end of a summer soccer game. The patient is lethargic and confused about the event. Upon assessment, the nurse notes flushed, dry skin that is warm to the touch. The oral mucosa is dry, as well. Vitals are as follows: temperature 40.7&deg;C, heart rate 122 bpm, respiratory rate 20, and blood pressure 116/64 mmHg. A rectal thermistor is inserted and aggressive cooling measures are instituted. After 30 minutes in the ice bath, the patient&rsquo;s rectal temperature is 39.1&deg;C and the ice is partially melted. Which action by the nurse is most important?

Accepted Answer

Replenish the ice in the ice bath while stirring the water around the patient. The patient should remain in the ice bath until the patient&rsquo;s rectal temperature has reached 38.9&deg;C. Ice should be replenished until the goal temperature is reached. Stirring the water ensures proper heat exchange between the water and the patient&rsquo;s skin. It is not yet appropriate to remove the patient from the ice bath. Allowing the ice to melt is less helpful. Ensuring contact of the head with the ice water is helpful for heat exchange, but replenishing the ice is more important.

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