{
  "id": "emergency/heatstroke-ice-water-immersion",
  "signature": "AI suggests giving oral water to a heatstroke victim, but ice-water immersion (4°C/39°F) is the gold standard for exertional heatstroke",
  "signature_zh": "AI建议给中暑患者喝水，但冰水浸泡（4°C/39°F）是劳力性中暑的金标准",
  "regex": "give\\s+(?:them|the\\s+victim)\\s+(?:water|fluids|to\\s+drink)\\s*(?:orally|by\\s+mouth)",
  "domain": "emergency",
  "category": "life_safety",
  "subcategory": null,
  "root_cause": "The AI conflates heat exhaustion (where oral rehydration is appropriate) with heatstroke (where rapid cooling via immersion in cold/ice water is critical, and oral fluids may cause aspiration or delay cooling).",
  "root_cause_type": "generic",
  "root_cause_zh": "AI混淆了热衰竭（可以口服补液）和中暑（必须通过冷水/冰水浸泡快速降温，口服液体可能导致误吸或延迟降温）。",
  "versions": [
    {
      "version": "ACSM Guidelines 2023",
      "introduced": null,
      "deprecated": null,
      "removed": null,
      "behavior_change": null,
      "status": "active"
    },
    {
      "version": "NATA Position Statement 2022",
      "introduced": null,
      "deprecated": null,
      "removed": null,
      "behavior_change": null,
      "status": "active"
    },
    {
      "version": "Wilderness Medical Society 2024",
      "introduced": null,
      "deprecated": null,
      "removed": null,
      "behavior_change": null,
      "status": "active"
    }
  ],
  "os_specific": {},
  "dead_ends": [
    {
      "action": "Recommending 'spray with water and fan' without immersion",
      "why_fails": "Evaporative cooling is slower than immersion for exertional heatstroke; core temp may not drop fast enough",
      "fail_rate": 0.7,
      "condition": "",
      "sources": []
    },
    {
      "action": "Telling users to 'give cold water enema'",
      "why_fails": "Unnecessary invasive procedure; immersion is safer and more effective without specialized equipment",
      "fail_rate": 0.9,
      "condition": "",
      "sources": []
    },
    {
      "action": "Advising 'apply ice packs to armpits and groin' only",
      "why_fails": "Ice packs alone are insufficient for rapid whole-body cooling; immersion is superior",
      "fail_rate": 0.75,
      "condition": "",
      "sources": []
    }
  ],
  "workarounds": [
    {
      "action": "Implement triage: 'If victim is unconscious or confused (heatstroke), do NOT give oral fluids. Immediately immerse in cold/ice water (4°C/39°F) if possible. Call 911.'",
      "success_rate": 0.92,
      "how": "Implement triage: 'If victim is unconscious or confused (heatstroke), do NOT give oral fluids. Immediately immerse in cold/ice water (4°C/39°F) if possible. Call 911.'",
      "condition": "",
      "sources": []
    },
    {
      "action": "Add decision tree: 'Is the victim sweating profusely and alert? Likely heat exhaustion—give water. Hot, dry skin and altered mental status? Heatstroke—cool first, no oral fluids.'",
      "success_rate": 0.88,
      "how": "Add decision tree: 'Is the victim sweating profusely and alert? Likely heat exhaustion—give water. Hot, dry skin and altered mental status? Heatstroke—cool first, no oral fluids.'",
      "condition": "",
      "sources": []
    },
    {
      "action": "Reference ACSM: 'For exertional heatstroke, cold-water immersion (4°C) until core temp < 38.9°C. This is the standard of care.'",
      "success_rate": 0.9,
      "how": "Reference ACSM: 'For exertional heatstroke, cold-water immersion (4°C) until core temp < 38.9°C. This is the standard of care.'",
      "condition": "",
      "sources": []
    }
  ],
  "workarounds_zh": [
    "Implement triage: 'If victim is unconscious or confused (heatstroke), do NOT give oral fluids. Immediately immerse in cold/ice water (4°C/39°F) if possible. Call 911.'",
    "Add decision tree: 'Is the victim sweating profusely and alert? Likely heat exhaustion—give water. Hot, dry skin and altered mental status? Heatstroke—cool first, no oral fluids.'",
    "Reference ACSM: 'For exertional heatstroke, cold-water immersion (4°C) until core temp < 38.9°C. This is the standard of care.'"
  ],
  "transition_graph": {
    "leads_to": [],
    "preceded_by": [],
    "frequently_confused_with": []
  },
  "official_doc_url": "https://www.acsm.org/docs/default-source/files-for-resource-library/exertional-heat-stroke.pdf",
  "official_doc_section": null,
  "error_code": "HEATSTROKE-COOL-ERR-005",
  "verification_tier": "ai_generated",
  "confidence": 0.91,
  "fix_success_rate": 0.85,
  "resolvable": "true",
  "first_seen": "2024-07-04",
  "last_confirmed": "2024-06-01",
  "last_updated": "2024-06-01",
  "evidence_count": 1,
  "tags": [],
  "locale": "en",
  "aliases": []
}