Answer:

Please keep in mind the esophageal temperature probe and foley probe may not be recording accurate temperatures. Can also try tympanic membrane, but the probe has to touch the TM. Rectal might be reflective of core, but not always.

Answer:

• Given the dramatic temperature increase associated with a MH crisis, use of all sorts of cooling therapy may be of benefit.
  
  For example, immersion cooling in a plastic swimming pool of ice water has been used for children.
  
  Adults may be more difficult to cool with cool IV fluids and topical cooling over key areas include groin/axillae ice packs, a cooling blanket thermal sandwich and both GI and Rectal Lavage with cooled saline. The internal surface area of the bowel and the stomach is great enough to increase cooling effectiveness.
  
  As or more important than rapid cooling is early recognition and rapid administration of IV dantrolene sodium.

• It is ineffective compared to gastric or bladder lavage, and it's messy!

• Dantrolene, cold IV fluids and if necessary gastric lavage are more than sufficient.