Ice Immersion Bags: Arizona EMS’ Lifesaving Approach to Heatstroke

Workers dealing with intense heat

Arizona is facing unprecedented heat levels, with temperatures consistently soaring above 110°F. This extreme heat poses severe health risks like heat exhaustion, heat stroke, and even death. In 2023, 645 people in the Phoenix area died from heat-related illnesses, according to the Associated Press. In response to the record-level heat, the state’s emergency medical services (EMS) have been mobilized to address the surge in heat-related emergencies, particularly heat stroke. A key component of their strategy is the use of human-sized ice immersion bags, based on methods used in sports medicine and the military.

Ice Immersion Bags: How They Work

To combat heat stroke and other heat-related illnesses, Arizona’s EMS teams have adopted advanced ice immersion bag protocols. These involve the following steps:

  1. Rapid Assessment and Diagnosis: When EMS personnel arrive on the scene, they quickly assess the patient for signs of heat stroke. Key indicators include a core body temperature above 104°F, altered mental state, rapid heart rate, and hot, dry skin.
  2. Immersion and Monitoring: Patients are placed inside an impermeable bag (often a body bag) with ice cubes packed around them which significantly lowers the body temperature within minutes, as reported by Seattle Times. The goal is to reduce the core body temperature to below 102°F as quickly as possible. EMS personnel then continuously monitor the patient’s vital signs, including temperature, heart rate, and oxygen levels. View a demonstration of the ice immersion technique by a Phoenix-area EMS captain.
  3. Transportation and Continued Care: After initial cooling, the patient is transported to the hospital for further treatment. During transport, EMS continues to monitor and manage the patient’s condition, ensuring stable vital signs and ongoing temperature control.
EMS worker demonstrating an ice immersion bag
Phoenix Fire Capt. John Prato demonstrated an immersion bag, which can be used to cool heat-stricken patients.Credit…Anita Snow/Associated Press

Effectiveness

The Journal of Emergency Medical Services highlights the effectiveness of the Arizona EMS teams’ approach for treating critically ill heatstroke patients. The Journal of the College of Emergency Physicians first documented the successful treatment of a heatstroke victim using ice immersion bags in 2020; an 87-year-old patient with a temperature of 104°F was immersed in a body bag packed with ice, reducing her temperature to 101.1°F within 10 minutes.
Cold water and ice bath immersion are effective heatstroke treatments as well, but they are difficult for EMS personnel to set up as quickly as ice immersion bags when treating a patient on site – and cool water may not be readily available depending on the location of the victim. It’s also a faster and easier solution for small community clinics who may not have adequate space and personnel for rapid setup of cooling baths.

Conclusion

As Arizona faces one of its hottest summers on record, the state’s EMS teams use of ice-filled cooling bags, combined with rapid response and monitoring, is saving the lives of heatstroke victims. By continuing to adapt and improve these protocols, Arizona and other state EMS services can effectively combat the growing threat of extreme heat and protect the health and safety of their communities.

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