Date of Graduation


Document Type


Degree Name

Master of Athletic Training (MAT)

Degree Level



Health, Human Performance and Recreation


Brendon P. McDermott

Committee Member

Jeff A. Bonacci

Second Committee Member

Matthew S. Ganio

Third Committee Member

Ramon C. Ylanan


Health and environmental sciences; Exertional heat stroke; Heat illness; Heat strain; Tarp-assisted cooling


Context: Recommended treatment of exertional heat stroke (EHS) includes whole body cold-water immersion (CWI); however, remote locations, spatial or monetary restrictions challenge CWI feasibility. Thus, the development of a modified, portable CWI method would allow for optimal treatment of EHS when restrictions apply. Objective: Determine cooling efficacy of modified CWI (tarp assisted cooling with oscillation; TACO) following exertional hyperthermia. Design: Randomized, crossover controlled trial. Setting: Environmental chamber (33.4 ± 0.8°C, 55.7 ± 1.9% relative humidity). Patients or Other Participants: Sixteen (9 males, 7 females) volunteers (26 ± 4.7y, 1.76 ± 0.09m, 72.5 ± 9.0kg, 20.7 ± 7.1%body fat) with no history of compromised thermoregulation participated. Interventions: Participants completed volitional exercise (cycling or treadmill) until a rectal temperature (Tre) ≥39.0°C. Following exercise, participants transitioned to a semi-recumbent position on a tarp until Tre reached 38.1°C or until 15 minutes elapsed during both control (no immersion; CON) and TACO (immersion in 151L of 2.1 ± 0.8°C water). Main Outcome Measures: Tre, heart rate (HR), and blood pressure (reported as mean arterial pressure, MAP), were assessed pre- and post-cooling. Statistical analyses included repeated measures ANOVA with appropriate post-hoc t-tests and Bonferroni correction. Results: Tre prior to cooling was not different between conditions (CON: 39.27 ± 0.26°C, CWI: 39.30 ± 0.39°C; P=0.62; ES=-0.09) whilst post-cooling Tre was decreased in TACO (38.10 ± 0.16°C) compared to CON (38.74 ± 0.38°C, t15=-8.84;P<0.001; ES=2.27). Cooling rate was significantly faster during TACO (0.14 ± 0.06°C/min) compared to CON (0.04 ± 0.02°C/min, P<0.001; ES=2.21). Decreases in heart rate did not differ between TACO and CON (t15=-1.81;P=0.09; ES=0.45). MAP was significantly greater post-cooling in TACO (84.2 ± 6.6mmHg) compared with CON (67.0 ± 9.0mmHg, P<0.001; ES=2.25). Conclusions: TACO provided significantly faster cooling than CON. When monetary or spatial restrictions are present, TACO represents an effective alternative to traditional CWI in emergency treatment of exertional hyperthermia.