Should cooling methods such as fanning and tepid sponging be used to manage pyrexia? What do you think?
The routine use of physical cooling methods such as tepid sponging and fanning are controversial. If the body’s natural defence mechanism to combat infection is to increase body temperature, why try to reduce it? Physical cooling methods may actually increase body temperature: they can stimulate a compensatory response by resulting in heat-generating activities such as shivering, which can compromise unstable patients by depleting their metabolic reserve.
There is no evidence to support the routine use of tepid sponging in temperate climates such as the UK and it does not produce a sustained drop in temperature. It can cause vasoconstriction, which can result in a further rise in patients’ temperature. If it is performed too quickly, it can cause them to shiver, which will increase metabolic rate and subsequently core body temperature. It is also time-consuming.
However, some authors recommend that physical cooling methods should be used if patients have potentially life threatening hyperpyrexia, heat stroke or malignant hyperthermia.
There is no doubt that a cool fan (not directly on patients) or cool flannel on the face can be very welcome when feeling hot. Reducing the amount of clothing and bedding can also help.
Phil Jevon is resuscitation officer and clinical skills lead at Manor Hospital, Walsall, West Midlands.