• Randi Manegold, David Fistera, Carola Holzner, and Joachim Risse.
• Centre of Emergency Medicine, University Medicine Essen, Germany. Electronic address: Randikatrin.manegold@uk-essen.de.
• Am J Emerg Med. 2020 Nov 1; 38 (11): 2488.e1-2488.e2.

AbstractIntranasal cooling by the evaporation of perflourcarbon is almost exclusively used for the induction of therapeutic hypothermia in post-resuscitation care. This method has proven to be effective and safe. This case presents a successful application to a patient with external heatstroke. The 80 year old male patient was found in deep coma (GCS 4) by emergency medical services (EMS) showing a core temperature around 42 °C. Despite of preclinical physical cooling, the patient showed a persistent temperature of 41.5 °C upon reaching the emergency department. After endotracheal intubation intranasal evaporation cooling was performed and the patient's core temperature was reduced efficiently. We recorded an excellent cooling rate of 2.8 °C per hour. 16 h later the patient was successfully extubated with a good neurological outcome. This case shows that although intranasal cooling is mostly known for post-resuscitation care, there is a sensible application in heatstroke with imminent cerebral oedema.Copyright © 2020 Elsevier Inc. All rights reserved.

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