Phoenix using ice immersion to treat heat stroke victims as Southwest bakes in triple digits

PHOENIX — The the first heat wave of the season The Southwest is already baking with triple-digit temperatures as firefighters in Phoenix — America’s hottest major city — employ new tactics in hopes of saving more lives in a county that saw 645 heat-related deaths last year.

Starting this season, the Phoenix Fire Department will immerse heatstroke victims in ice on their way to area hospitals. The medical technique, known as cold water immersion, is well known to marathon runners and military personnel and has also recently been adopted by Phoenix hospitals as a standard protocol, Fire Capt. John Prato said.

Prato demonstrated the method outside the emergency department at Valleywise Health Medical Center in Phoenix earlier this week, wrapping ice cubes in an impermeable blue bag around a medical doll representing a patient. He said the technique can dramatically lower body temperature within minutes.

“Last week we had a critical patient that we were able to bring back before we even walked through the emergency room doors,” Prato said. “That is our goal: to improve patients’ chances of survival.”

Due to heatstroke treatment, ice and human-sized immersion bags are standard equipment on all Phoenix Fire Department emergency vehicles. It is one of several measures the city has taken this year as temperatures and their human toll continue to rise. Phoenix also keeps two for the first time cooling stations open at night this season.

Emergency workers across much of an area stretching from southeastern California to central Arizona are preparing for what the National Weather Service says would be “easily their hottest” weather since last September.

Excessive heat warnings have been issued for parts of southern Nevada and Arizona for Wednesday morning through Friday evening, with highs expected to exceed 110 degrees Fahrenheit (43.3 degrees Celsius) in Las Vegas and Phoenix. The unusually warm weather was expected to spread north and make its way into parts of the Pacific Northwest by the weekend.

Officials in Maricopa County were stunned earlier this year when final numbers showed 645 heat-related deaths in Arizona’s largest county, the majority of them in Phoenix. The most brutal period was a heat wave with 31 consecutive days of temperatures of 43.4 degrees Celsius or higher, which claimed more than 400 lives.

“We have seen a serious increase in the number of cases of severe heat illness over the past three years,” said Dr. Paul Pugsley, medical director of emergency medicine at Valleywise Health. Of those, about 40% do not survive.

Cooling patients down long before they go to the emergency department could change the equation, he said.

The technique “is not very widespread in non-military hospitals in the US, nor in the prehospital setting among fire departments or first responders,” Pugsley said. He said part of that may have to do with the long-standing perception that using the technique for all heatstroke cases by first responders or even hospitals was impractical or impossible.

Pugsley said he was aware of limited use of the technique in some places in California, including Stanford Medical Center in Palo Alto and Community Regional Medical Center in Fresno, and by the San Antonio Fire Department in Texas.

Banner University Medical Center in Phoenix embraced the protocol last summer, said Dr. Aneesh Narang, assistant medical director of emergency medicine there.

“This cold water immersion therapy is really the standard of care for treating patients with heatstroke,” he said.