External Surface Cooling

External surface cooling depends on conductive loss of heat from the skin surface. Various methods can be used, including the direct application of ice, cold water, forced cold air, cold water-containing blanket, or cooled gel-containing surface pads. Cold ice packs can reduce core temperature by 0.9°C/hr (60,61); however, this is a labor-intensive method and can result in damage to the skin with prolonged periods of direct ice-to-skin contact. Cold-air cooling is even slower, at a rate of 0.3°C/hr to 0.5°C/hr (62,63). Cold water-containing blankets have been compared to forced cold-air cooling, and no significant advantages have been found with either method (64).

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