Cold water immersion (CWI) has been the clinically recommended treatment for exertional heat stroke (EHS) for years. What's changed in 2026 is adoption: departments of every size, in every kind of climate, are moving CWI from a hospital-only intervention to standard equipment on the truck. Five recent cases show what that shift actually looks like on the ground, and what still separates a working protocol from a paper one.

Oklahoma City Fire Department: bringing CWI to transport crews

OKCFD transport crews are among the first in Oklahoma to carry cold water immersion for heat emergencies, a shift that puts the "cool first, transport second" principle directly into ambulance-based care rather than leaving it to suppression crews or hospitals alone. → Read the full article

Phoenix Fire Department: proving it works at scale, then off-road

Phoenix's 2024 urban CWI program is the most studied in the country, with peer-reviewed data showing improved outcomes across 300+ patients. In 2026, the department's mountain rescue numbers, up more than 50% year over year, are testing whether the same standard of cooling can be delivered without a road to the patient. → Read the full article

Northwest Allen County Fire Protection District: CWI isn't just for big cities

This rural Indiana department equipped crews with rapid cooling gear in July 2026, showing that a 100% survival statistic and a "cool first" protocol apply regardless of department size or budget, even when the logistics have to be solved with a local ice-vendor agreement. → Read the full article

Miami-Dade Fire Rescue: writing the protocol down

Miami-Dade's Procedure 60 formalizes CWI and TACO methods, including clear direction for the common event-medicine scenario where cooling is already staged by athletic trainers or event staff before fire-EMS arrives. → Read the full article

El Dorado County EMS: giving crews a precise stopping point

El Dorado County's 2026 protocol defines an exact 102°F discontinuation threshold for CWI, closing a gap that leaves many agencies' protocols ambiguous about when cooling should end. → Read the full article

What all five have in common

Every one of these departments is working around the same limitation: the equipment available to most fire-EMS agencies, improvised tarps, kiddie pools, closed ice bags, or bulky rigid tubs, forces a trade-off between speed, patient access, and reliability. Bag-based systems close off airway and vitals monitoring during cooling. Tarps and makeshift pools are slow to set up and prone to leaking under repeated field use. Rigid tubs eat compartment space that's already contested by other medical equipment. None of these constraints are about whether CWI works, the clinical case has been settled since the ACSM 2023 Expert Consensus Statement and the Korey Stringer Institute's documented 100% survival rate across 401+ cases. They're about whether a department can put a reliable version of it on every truck, every call.

Why Kollder is built for exactly this gap

Kollder One™ was designed around the operational constraints these five departments are each solving independently: a stainless steel immersion tub that one person deploys in under 2 minutes, packs to 85×10×10 cm at 11.1 kg, and gives full 360° patient access throughout cooling, so crews can monitor airway and vitals, and confirm a temperature endpoint, without lifting the patient out of the water. It doesn't depend on a water main, a same-day ice order, or a second responder to set up. That combination is what turns "we know CWI works" into "every apparatus carries equipment that makes it usable in under 2 minutes", the same gap our earlier piece on the French SDIS model identified as the real driver of adoption speed, more than the science itself.

Departments evaluating equipment for prehospital, wilderness, or event-medicine CWI can review full specifications and request a quote at kollder.com/#contact.

Pour aller plus loin / Further Reading

Sources: KFOR News 4; ABC15 Arizona; WPTA-TV (21Alive); Miami-Dade County Procedure 60; El Dorado County EMS Protocol 502; ACSM Expert Consensus Statement 2023; Korey Stringer Institute, University of Connecticut.

Kollder is the emergency cooling tub that deploys in under 2 minutes, anywhere.

Request a quote