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AI-DRAFTED — PHYSICIAN REVIEW IN PROGRESSThe citation for this entry was checked against Crossref and PubMed, but its summary and interpretation were drafted by an AI model from the published abstract and have not yet been individually read by a physician. Read the linked source before relying on this operationally.
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Physician Directed Prehospital Treatment in Psychostimulant Induced Hyperthermia: A Case Series[1]

Habrat DA, Dukes WS, Neeki MM, Schlesinger SA · 2025 · Prehosp Emerg Care

Summary

Retrospective case series of 21 psychostimulant-induced hyperthermia patients treated at EDM festivals by physician-led prehospital teams using an event-medicine guideline: on-scene sedation, intubation, then ICE-WATER SUBMERSION before transport to non-specialized EDs. Median initial rectal temperature 42.2 C (IQR 41.8-42.4). Eighteen completed submersion cooling, arriving at EDs with mean core temperature 35.9 C; three arrested before/during cooling and required removal plus CPR. Outcomes: 19 of 21 survived to admission; 18 discharged neurologically intact. Authors present it as the largest physician-directed out-of-hospital series at music festivals and conclude on-site immersion before transport can reduce mortality.

So what

The operational answer to the cooling-delay problem the library already documents: Armenian measured 2.7 hours to cooling with transport-first care and 2 deaths in 12; Habrat's teams submerged on site and discharged 18 of 21 neurologically intact from median 42.2 C — the strongest outcome data yet for aggressive festival-side treatment. It also validates the full bundle (sedate, intubate, submerge, then transport ANYWHERE) rather than specialized-center triage. This is the protocol citation for MGMI's dance-event heat/tox pages and the practical fulfillment of the Hall & Henry management frame.

Key findings

  • 21 festival psychostimulant hyperthermia cases, median rectal temp 42.2 C
  • Guideline: on-scene sedation + intubation + ice-water submersion before transport
  • 18/21 discharged neurologically intact; 19/21 survived to admission
  • ED arrival core temp mean 35.9 C - cooling completed BEFORE hospital
  • Direct counterpoint to transport-first care (Armenian: 2.7h to cooling, 2/12 dead)

Read the paper