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학습 자료 둘러보기 →In paroxysmal sympathetic hyperactivity (PSH), fever is driven by peripheral sympathetic outflow, not a hypothalamic set-point shift. Immediate priority is external cooling (blankets, ice packs to pulse points) to reduce cerebral metabolic demand and intracranial pressure (ICP).
Antipyretics like acetaminophen are ineffective for PSH because the mechanism is not prostaglandin-mediated. Cooling must be rapid to prevent secondary brain injury; a temperature of 104°F (40°C) is a neurological emergency.
Aggressively control shivering during cooling to avoid increased metabolic heat and ICP. Do not delay cooling for diagnostic workup like blood cultures; temperature reduction and hemodynamic stability take precedence.
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