Unusual hazard of outdoor CPR on a very hot day

We report a case of a patient who suffered first and second degree burns after prolonged cardiopulmonary resuscitation (CPR) on hot asphalt. At noon on a very hot day, the emergency medical system was called to a 56-year old man who had collapsed on a road. He had 15min of bystander CPR before paramedics arrived. The paramedics did advanced CPR for another 30min with the patient still lying on the ◦ ◦ asphalt road. The outside temperature was 39 C (102 F) and the humidity was 65%. The patient was wearing light clothes. Once restoration of a spontaneous circulation was achieved, the patient was transferred to the intensive coronary care unit. On physical examination, the patient had first