Fighting Fire with Ice: A Multisite Collaboration to Evaluate the Impact of Prehospital Cold Water Immersion on Heat Stroke Patients

A prehospital CWI protocol is feasible in a large urban EMS system and provides rapid temperature reduction and improved neurologic status in patients with heat stroke. The findings suggest a meaningful clinical benefit and broad operational feasibility. Further prospective, multicenter studies are needed to define the resulting impact, optimize workflows, and guide wider adoption of prehospital immersion cooling.