Abstract
Background: External cooling is a traditional method of promoting patient comfort as well as being a routine practice for antipyretic therapy. There has been controversy, however, about the indications for application of antipyretic therapy including external cooling for febrile patients in ICU due to the potential side effects of external cooling. We therefore investigated the understanding of antipyretic therapy and application of external cooling by Japanese ICU nurses (ICNs). Methods: We conducted a written questionnaire survey among ICNs at 7 ICUs. Results: We received 197 responses. The definition of fever by ICNs was 37.5 [37.15–38.0] °C (median [interquartile range]) , and the body temperature threshold for application of external cooling was 38.0 [38.0–38.5] °C. Ninety-nine percent of ICNs selected ice pack/pillow for external cooling. External cooling was recognized as an effective method of reducing fever by 85.1% of respondents. Cooling was applied at the patient's request (78.6%) and in response to increased body temperature (84.2%). Cooling practice did not change due to the sedation level in 44.7% of responses, and did not change due to infectious state in 70.7% of responses. Conclusions: Insufficient knowledge and inappropriate decision making for application of cooling by ICNs is suggested.
