The use of rectal temperature to monitor heat stroke

The diagnosis and treatment of heat stroke has relied on rectal temperature monitoring. A twenty-year retrospective review of heat stroke and heat exhaustion victims reveals a 24% mortality and a 33% incidence of overcooling. An experimental protocol using hot and cool baths demonstrates marked rectal temperature lag during periods of rapid body heating and cooling. Auditory canal temperature measurements provide an attractive alternative to rectal temperature measurement during rapid temperature change. Rectal temperature monitoring of heat stroke victims is not recommended. This work suggests that shivering during treatment of heat stroke might be the result of vascular and brain overcooling with elevated rectal temperatures.