Objective To evaluate and summarize the best evidence of pre-hospital cooling care for exertional heat stroke（EHS）and provide basis for clinical pre-hospital cooling care. Methods We systematically searched BMJ Best Practice,UpToDate,Scottish Colleges Guideline Website,National Institute of Clinical Medicine,National Guideline Clearinghouse of USA,Joanna Briggs Institute Library,New Zealand Guidelines Collaborative,Registered Nurses' Association of Ontario,Canada Clinical Practice Guidelines,China Practical Guidelines Registration Platform,Nursing Consult,Cochrane Library,PubMed,China Biomedical Literature Database,CNKI,Wanfang and Yi Maitong for evidence on prehospital cooling care for exertional heat stroke,including guidelines,expert consensus,clinical decision-making and systematic review. The retrieval time limit was from the establishment of the database to December 31,2022. The literature quality evaluation and data extraction were performed by two researchers. Results A total of 10 articles were included,including one guideline,eight expert consensuses and one systematic review. Finally,21 pieces of best evidence were summarized from 4 aspects. Conclusion The summarized nursing evidence of EHS prehospital cooling can provide reference for clinical medical staff or emergency personnel,and help to reduce the organ damage rate and mortality caused by EHS.
[1] Roberts WO.Common threads in a random tapestry:another viewpoint on exertional heatstroke[J]. Phys Sportsmed,2005,33(10):42-49.
[2] Xia DM,Wang XR,Zhou PY,et al.Research progress of heat stroke during 1989-2019:a bibliometric analysis[J]. Mil Med Res,2021,8(1):5.
[3] American College of Sports Medicine,Armstrong LE,Casa DJ,et al. American College of Sports Medicine position stand. Ex-ertional heat illness during training and competition[J]. Med Sci Sports Exerc,2007,39(3):556-572.
[4] Gauer R,Meyers BK.Heat-related illnesses[J]. Am Fam Physician,2019,99(8):482-489.
[5] Hosokawa Y,Racinais S,Akama T,et al.Prehospital management of exertional heat stroke at sports competitions:international Olympic Committee Adverse Weather Impact Expert Working Group for the Olympic Games Tokyo 2020[J]. Br J Sports Med,2021,55(24):1405-1410.
[6] 全军热射病防治专家组,热射病急诊诊断与治疗专家共识组. 热射病急诊诊断与治疗专家共识(2021版)[J]. 中华急诊医学杂志,2021,30(11):1290-1299.
Expert Group for the Prevention and Treatment of Heat Emi-ssion Disease of the Whole Army,Expert Consensus Group for the Emergency Diagnosis and Treatment of Heat Emission Disease. Expert consensus on emergency diagnosis and treatment of thermal radiation disease(2021 edition)[J]. Chin J Emerg Med,2021,30(11):1290-1299.
[7] Epstein Y,Yanovich R.Heatstroke[J]. N Engl J Med,2019, 380(25):2449-2459.
[8] 刘树元,汪茜,邢令,等. 劳力型热射病器官损伤机制与救治策略[J]. 武警医学,2020,31(5):450-454.
Liu SY,Wang Q,Xing L,et al.Organ damage mechanism and treatment strategy of labor-induced heatstroke[J]. Med J Chin People's Armed Police Forces,2020,31(5):450-454.
[9] Mueller FO,Cantu RC. Catastrophic sports injury research:twenty-sixth annual report. University of North Carolina,Chapel Hill2008[EB/OL].[2023-04-26]. https://nccsir.unc.edu/wp-content/uploads/sites/5614/2014/05/AllSport.pdf.
[10] Alele FO,Malau-Aduli BS,Malau-Aduli AEO,et al.Epidemiology of exertional heat illness in the military:a systematic review of observational studies[J]. Int J Environ Res Public Health,2020,17(19):7037.
[11] Belval LN,Casa DJ,Adams WM,et al.Consensus statement-prehospital care of exertional heat stroke[J]. Prehosp Emerg Care,2018,22(3):392-397.
[12] 朱政,胡雁,周英凤,等. 推动证据向临床转化(三)研究的选题和问题构建[J]. 护士进修杂志,2020,35(9):796-799.
Zhu Z,Hu Y,Zhou YF,et al.Promoting the transformation of evidence to clinical practice:research topic selection and problem construction[J]. J Nurses Train,2020,35(9):796-799.
[13] Brouwers MC,Browman GP,Burgers JS,et al. Appraisal of gui-delines for research & evaluation Ⅱ[EB/OL].(2017-12)[2023-04-26]. http://www.agreetrust.org.
[14] 周芬,郝玉芳,丛雪,等. 指南研究与评价工具AGREE Ⅱ及各领域分值的补充解释及思考[J]. 护理学报,2018,25(18):56-58.
Zhou F,Hao YF,Cong X,et al.Supplementary explanation and thinking of AGREE Ⅱ,a guide research and evaluation tool,and scores in various fields[J]. J Nurs,2018,25(18):56-58.
[15] 胡雁. 循证护理学[M]. 北京:人民卫生出版社,2012.
Hu Y.Evidence-based nursing[M]. Beijing:People's Medical Publishing House,2012.
[16] 熊俊,陈日新. 系统评价/Meta分析方法学质量的评价工具AMSTAR[J]. 中国循证医学杂志,2011,11(9):1084-1089.
Xiong J,Chen RX.An introduction to a measurement tool to assess the methodological quality of systematic reviews/meta-analysis:AMSTAR[J]. Chin J Evid Based Med,2011,11(9):1084-1089.
[17] 王春青,胡雁. JBI证据预分级及证据推荐级别系统(2014版)[J]. 护士进修杂志,2015,30(11):964-967.
Wang CQ,Hu Y.JBI evidence pre-classification and evidence rank system(2014 Edition)[J]. J Nurses Train,2015,30(11):964-967.
[18] Lipman GS,Gaudio FG,Eifling KP,et al.Wilderness medical society clinical practice guidelines for the prevention and treatment of heat illness:2019 update[J]. Wilderness Environ Med,2019,30(4S):S33-S46.
[19] Casa DJ,DeMartini JK,Bergeron MF,et al. National athletic trainers' association position statement:exertional heat illnesses[J]. J Athl Train,2015,50(9):986-1000.
[20] Roberts WO,Armstrong LE,Sawka MN,et al.ACSM expert consensus statement on exertional heat illness:recognition,management,and return to activity[J]. Curr Sports Med Rep,2023,22(4):134-149.
[21] 刘树元,宋景春,毛汉丁,等. 中国热射病诊断与治疗专家共识[J]. 解放军医学杂志,2019,44(3):181-196.
Liu SY,Song JC,Mao HD,et al.Expert consensus on diagnosis and treatment of heatstroke in China[J]. Med J Chin PLA,2019,44(3):181-196.
[22] Filep EM,Murata Y,Endres BD,et al.Exertional heat stroke,modality cooling rate,and survival outcomes:a systematic review[J]. Medicina(Kaunas),2020,56(11):589.
[23] 宁波,刘树元,宋青. 暑期部队高强度训练预防中暑专家共识[J]. 空军医学杂志,2019,35(04):283-288.
Ning B,Liu SY,Song Q.Expert consensus on high-intensity training to prevent heatstroke in summer troops[J]. Med J Air Force,2019,35(4):283-288.
[24] Heled Y,Rav-Acha M,Shani Y,et al.The “golden hour” for heatstroke treatment[J]. Mil Med,2004,169(3):184-186.
[25] Lee JK,Kenefick RW,Cheuvront SN.Novel cooling strategies for military training and operations[J]. J Strength Cond Res,2015,29(Suppl 11):S77-S81.
[26] Casa DJ,Kenny GP,Taylor NA.Immersion treatment for exertional hyperthermia:cold or temperate water?[J]. Med Sci Sports Exerc,2010,42(7):1246-1252.
[27] Casa DJ,McDermott BP,Lee EC,et al. Cold water immersion:the gold standard for exertional heatstroke treatment[J]. Exerc Sport Sci Rev,2007,35(3):141-149.
[28] Bouchama A,Dehbi M,Chaves-Carballo E.Cooling and hemo-dynamic management in heatstroke:practical recommendations[J]. Crit Care,2007,11(3):R54.
[29] Demartini JK,Casa DJ,Stearns R,et al.Effectiveness of cold water immersion in the treatment of exertional heat stroke at the Falmouth Road Race[J]. Med Sci Sports Exerc,2015,47(2):240-245.
