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A national protocol can be lifesaving for patients with heat illness. Only 11 states require it.
During football practice in Fort Myers, Florida, 17-year-old Zach Martin collapsed. His body temperature hit 107 degrees, and when the ambulance arrived on the scene, he was unresponsive and moaning, according to his mother Laurie Giordano.
“I just remember the panic that was setting in in that moment,” Giordano said. “They were just assessing him and then loading him up.”
But what Giordano didn’t know is that when a patient is overheated, the national recommendation is not to load the patient and rush them to the hospital. It’s a technique called “Cool First, Transport Second.” In that process, a patient’s body temperature is brought back down before they are transported to the hospital. It can be lifesaving. However, just 11 states require ambulance services to follow that protocol.
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Zach died from organ failure 11 days after his collapse. Giordano believes that her “gentle and kind and funny” son could have survived if “Cool First, Transport Second” had been followed.
“As a mother, that first heartbeat is really important to hear on the sonogram,” Giordano said. “I heard his last heartbeat too.”
What is “Cool First, Treat Second?”
Matt Willens is a paramedic who practices “Cool First, Transport Second” when treating a patient who is experiencing extreme heat illness.
The process starts with ice. Then, the patient is loaded into a bag. Ice and water are poured in, and the bag is zipped, with one arm hanging out so Willens can monitor the patient’s blood pressure. This impromptu ice bath allows the patient to cool down rapidly, reducing the impacts of heat illness.
“Now we’re treating them in the field and making that difference and that could save their life,” Willens explained. “That is going to save their life.”
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The National Association of EMS Officials recommends this protocol when a patient’s core temperature is above 104 degrees Fahrenheit. The patient should remain in the ice bath until their body temperature falls to 102.2 degrees. Then, they can be transported to the hospital.
Preparing for heat illness in a warming world
“Cool First, Transport Second” is more critical than ever as climate change makes summers hotter and hotter. Multiple dangerous heat waves struck the United States in 2024, and excessive heat is the No. 1 cause of weather-related deaths in the United States. Around the world, rising temperatures have caused hundreds of deaths this year.
Heat illness is likely to become more common. A study from the National Institutes of Health found that cardiovascular deaths due to extreme heat are projected to increase in the U.S. between 2036 and 2065, CBS News previously reported, with older and Black adults likely to be disproportionately affected.
Children are also more vulnerable to extreme heat. More than 9,000 high school athletes like Zach are treated for heat-related illnesses every year.
After years of advocacy, Giordano worked with the Florida legislature to pass a law requiring an on-site ice bath at all outdoor high school athletic events. The law, known as the “Zachary Martin Act,” also requires schools to learn about how to treat excessive heat, modify athletic activities based on temperature, and require coaches to complete annual training about how to identify and treat heat illness.
“If you can, if we can get the first response to be cool, then then that’s gonna be where where the lives are saved,” Giordano said.
Giordano said she’s not stopping with high schools. She wants all of the nation’s ambulances to cool heat victims on the spot.
“Everybody has heat waves in this country,” Willens said. “And this is the future of how these heat emergencies should be treated.”
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President-elect Donald Trump fired another salvo in his long-running effort to have his New York criminal conviction tossed, with his attorneys alleging earlier this month that there was juror misconduct during his trial.
In a previously undisclosed Dec. 3 letter to Justice Juan Merchan that was made public Tuesday, Todd Blanche and Emil Bove wrote that there was “grave juror misconduct” in the proceedings in a Manhattan courtroom earlier this year.
However, heavy redactions in the letter and subsequent exchanges with prosecutors obscured almost all information about the accusations themselves.
“The jury in this case was not anywhere near fair and impartial,” they wrote.
Merchan on Tuesday directed Trump to make the redacted letter public, and instructed prosecutors to publish their own redacted responses. The judge also criticized Trump’s lawyers for making such serious allegations without sworn statements.
Prosecutors called the allegations “vague accusations of juror misconduct” in one of their responses. They claimed Trump’s attorneys did not want to have the allegations subject to investigation or a public hearing.
“Notwithstanding the import of their allegations, counsel do not request and in fact oppose a hearing at which their allegations could be fully examined, referring to such a hearing as ‘invasive fact-finding,'” wrote a prosecutor for Manhattan District Attorney Alvin Bragg.
Still, they argued such an investigation wasn’t yet appropriate.
“Counsel’s allegations fall far short of the standard required to request such a hearing in any event,” they wrote.
It is unclear if the allegations relate to a June 7 letter from Merchan that alerted prosecutors and Trump’s attorneys to a comment left on the court’s Facebook page the night before Trump’s conviction.
“My cousin is a juror and says Trump is getting convicted,” the user wrote. “Thank you folks for all your hard work!!!!”
The person who made the comment had previously described themselves as a “professional s**tposter.”
Trump was found guilty in May of 34 counts of falsifying business records, connected with a scheme to cover up a “hush money” payment to an adult film star. He pleaded not guilty and is contesting the conviction on multiple fronts.
Japanese automakers Honda Motor and Nissan Motor are reportedly entering merger talks to help them compete against Tesla and other electric vehicle makers, according to the Nikkei financial newspaper.
The two firms are considering operating under a single holding company, and are expected to sign a memorandum of understanding for the new entity, according to the Tokyo-based Nikkei.
The paper also reports that Honda and Nissan are considering bringing in Mitsubishi Motors, of which Nissan is the top shareholder, under the holding company to create one of the world’s largest auto groups.
In a statement to CBS MoneyWatch, Nissan said it has not announced the details in the report, but that the two companies “are exploring various possibilities for future collaboration, leveraging each other’s strengths,” which it announced in March.
Honda did not immediately respond to CBS MoneyWatch’s request for comment.
In March, Japan’s number two and three automakers, after rival Toyota, deepened ties when they agreed to explore a strategic partnership on electric vehicles.
Analysts characterized the move as one that is aimed at helping the automakers catch up with Chinese competitors, including BYD, which have captured more market share, while Japanese firms have lost ground by focusing more on hybrid vehicles.
China overtook Japan as the world’s biggest vehicle exporter in 2023, aided in part by its dominance in the electric car space.
Honda announced plans in May to double its investment in electric vehicles to $65 billion by 2030, as part of a target set three years ago of achieving 100% EV sales by 2040.
Similarly, Nissan in March announced that 16 of the 30 new models it plans to launch over the next three years would be “electrified.”
Climate concerns drive demand
The world’s auto giants are increasingly prioritizing electric and hybrid vehicles, with demand growing for less polluting models as concern about climate change grows.
At the same time, however, consumer demand for EVs has slowed amid high prices, range anxiety and developing infrastructure around charging points.
Hybrids that combine battery power and internal combustion engines have remained popular in Japan, accounting for 40% of sales in 2022.
But Japanese firms’ focus on hybrids has left them in the slow lane in meeting the growing appetite for purely electric vehicles. Just 1.7% of cars sold in Japan in 2022 were electric, compared to 15% in western Europe and 5.3% in the United States.
