Objective To compare the cooling effects of ice packs with different media and biological ice packs on high-fever patients after cranio-cerebral injury. Methods Totally 100 ICU high-fever patients requiring physical cooling after cranio-cerebral injury in neurosurgery department were randomized into 5 groups, with 20 patients in each group. Each group received cold compress using ice packs with water, 10% saline solution, 25% ethanol, 10% glauber′s salt and biological ice packs respectively, and standard cooling procedures were adopted by nurses for the patients.The axillary temperature of each group at different time points and the replacement frequency of ice pack were recorded. Results The time effect was significant in temperature change for each group (P＜0.05).During the cooling process, the group compressed with biological ice pack replaced ice packs the most, while the group compressed with 25% ethanol replaced ice packs the least (P＜0.05). Conclusion Cold compress using ice packs with the 5 diffe-rent media can afford continuous cooling for high-fever patients after cranio-cerebral injury. After 180 minutes cooling, 25% ethanol ice pack exhibits superior cooling efficiency over other groups, and less replacement is required, thus it has the priority for cold therapy.