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Summary SEVERE HEAT

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Heat Stroke..................................................................................................................................... 1 Heat and Human Body............................................................................................................... 1 Types of Heat Stroke.................................................................................................................. 2 Key Steps in Heat Stroke Management ..................................................................................... 3 Key Points: Severe Heat-Related Illnesses (HRI)...................................................................... 3 Guiding Principles: Rapid Cooling in Severe Heat-Related Illnesses....................................... 3 Cooling rates.............................................................................................................................. 5 Challenges with Rapid Cooling ................................................................................................. 5 Follow-up of Heat Stroke Treatment ......................................................................................... 6 2. Cooling methods ............................................................................................................................ 9 A. Conductive cooling.................................................................................................................. 9 B. Evaporative and Convective Cooling .................................................................................... 17 C. Evaporative + Convective + Conductive Cooling ................................................................. 18 D. Invasive Cooling Measures.................................................................................................... 19 E. Other cooling methods........................................................................................................... 19 3. Emergency Cooling in Children................................................................................................... 20 Guiding Principles: Rapid Cooling in Children....................................................................... 20 Cooling methods...................................................................................................................... 21 4. Public Health Aspects................................................................................................................... 22 Health sector preparedness for emergency cooling of severe HRI.......................................... 22 Community level preparedness for rapid cooling of severe HRI............................................. 23 Mass participation sports events/ mass gathering event

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EMERGENCY COOLING
FOR

SEVERE HEAT RELATED
ILLNESSES




National Centre for
Disease Control
Government of India

,
, Acknowledgement
These guidelines on Emergency Cooling for Severe Heat-Related Illnesses are prepared
under National Programme on Climate Change and Human Health (NPCCHH), National
Centre for Disease Control (NCDC), MoHFW. Aligned with the programme's goal, the
guidelines emphasize the significance of rapid and active cooling in addressing severe
heat-related illnesses. With a specific focus on various body cooling methods, the
guidelines are envisioned to support the incorporation of this approach into emergency
care throughout the healthcare system, adapting to the increasing climate change and
extreme heat events.

These guidelines supplement earlier publications, i.e., National Action Plan on Heat
Related Illnesses (2021) and Strengthening Health Systems Preparedness for Heat
Related Illnesses in India (2023). NPCCHH Programme Implementation Plan (PIP)
provides procurement guidance for emergency cooling measures.

These guidelines were conceptualized under the vision and leadership of Prof (Dr) Atul
Goel, DGHS and Director, NCDC. The expert committees of clinicians from internal
medicine and paediatrics contributed to their development. We thank Prof (Dr) Ajay
Chauhan, Atal Bihari Vajpayee Institute of Medical Sciences & Dr. Ram Manohar Lohia
Hospital, New Delhi, for technical guidance and detailed review.


DGHS Committee members (Internal medicine)
Dr. Ajay Chauhan, Professor, Atal Bihari Vajpayee Institute of Medical Sciences & Dr.
Ram Manohar Lohia Hospital
Surg Capt Anuj Singhal, Sr. Advisor, Army Hospital Research and Referral
Dr. Arvind Kumar, Consultant, All India Institute of Medical Science-New Delhi
Dr. Sanjay Kumar, Professor, Lady Hardinge Medical College
Dr. L. H. Ghotekar, Professor, Lady Hardinge Medical College
Dr. Vinod Chaitanya, Professor, Vardhman Mahavir Medical College & Safdarjung
Hospital

DGHS Committee members (Paediatrics)
Dr. Shalu Gupta, Director-Professor, Lady Hardinge Medical College
Col S C Shaw, Sr. Advisor, Army Hospital Research and Referral
Dr. Rattan Gupta, Professor, Vardhman Mahavir Medical College & Safdarjung Hospital
Dr. Rakesh Lodha, Professor, All India Institute of Medical Science-New Delhi
Dr. Vivek Dewan, Professor, Atal Bihari Vajpayee Institute of Medical Sciences & Dr.
Ram Manohar Lohia Hospital

Members from National Programme on Climate Change and Human Health
Dr. Aakash Shrivastava, Additional Director & Head, CEOH&CCH, NCDC
Dr. Purvi Patel, Senior Consultant, NPCCHH, NCDC
---

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