Construction and application of an early in-hospital temperature management protocol for patients with heat stroke
10.3761/j.issn.0254-1769.2025.05.008
- VernacularTitle:热射病患者院内早期体温管理方案的构建及应用研究
- Author:
Lan CHEN
1
;
Huimin MA
;
Yuan FANG
;
Huan ZHANG
;
Jingnan REN
;
Liyun LU
;
Xiangliang WU
;
Chang LIU
;
Dingping JIN
;
Xiuqin FENG
Author Information
1. 310009 杭州市 浙江大学医学院附属第二医院护理部
- Publication Type:Journal Article
- Keywords:
Heat Stroke;
Temperature Management;
Early Intervention;
Delphi Technology;
Nursing Care
- From:
Chinese Journal of Nursing
2025;60(5):561-568
- CountryChina
- Language:Chinese
-
Abstract:
Objective This study aims to develop an early in-hospital temperature management protocol for heat stroke patients and assess its effectiveness,providing guidance for rapid cooling and precise target temperature control.Methods The protocol was developed through a Delphi expert consultation combined with expert panel meetings.A multi-center,non-randomized,historical control study was conducted,utilizing convenience sampling to select heat stroke patients from the emergency departments of 7 tertiary hospitals in Zhejiang Province,China,between June and August 2024 as an experimental group.The protocol was implemented in this group,while the control group consisted of heat stroke patients treated between June and August 2022,prior to protocol implementation.Cooling rates,target temperature attainment rates,and clinical outcomes were compared between the 2 groups.Results The final protocol included 6 primary indicators,23 secondary indicators,and 56 tertiary indicators.After protocol implementation,the experimental group achieved a cooling rate of 0.08(0.05～0.09)℃/min within 0.5 hours,significantly higher than the control group,which had a rate of 0.04(0.02～0.06)℃/min(P＜0.001).The target temperature attainment rates at 0.5 hours and 2.0 hours were 55.93％and 98.31％,respectively,significantly higher than the rates of 15.87％and 61.11％in the control group(P＜0.001).The mechanical ventilation rate,hospitalization rate,ICU admission rate,and mortality rate in the experimental group were 25.42％,61.02％,44.07％,and 8.47％,respectively.Logistic regression analysis revealed that the early in-hospital temperature management protocol significantly reduced the risk of mechanical ventilation and hospitalization in heat stroke patients,with odds ratios(ORs)of 0.294 and 0.300,respectively(both P＜0.05).Conclusion The developed protocol for early in-hospital temperature management in heat stroke patients is scientific,systematic,and practical.It improves cooling rates and target temperature attainment,thereby enhancing the prognosis of heat stroke patients.
