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SGEM#391: Is it Time for a Cool Change (Hypothermia After In-Hospital Cardiac Arrest)?

The Skeptics' Guide to EM

You are tidying your things […] The post SGEM#391: Is it Time for a Cool Change (Hypothermia After In-Hospital Cardiac Arrest)? Are we supposed to be starting hypothermia?” The hypothermia group was cooled using an external device to a target temperature between 32 and 34 degrees Celsius and maintained there for 24 hours.

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SGEM#275: 10th Avenue Freeze Out – Therapeutic Hypothermia after Non-Shockable Cardiac Arrest

The Skeptics' Guide to EM

Case: A 59-year-old […] The post SGEM#275: 10th Avenue Freeze Out – Therapeutic Hypothermia after Non-Shockable Cardiac Arrest first appeared on The Skeptics Guide to Emergency Medicine. Background: We have covered therapeutic hypothermia many times on the SGEM. Date: November 6th, 2019 Reference: Lascarrou et al.

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Hyperthermia and ST Elevation

Dr. Smith's ECG Blog

Alexandra Schick ( with edits by Dr. Smith ) of an elderly woman who was seen in the ED for altered mental status, hyperthermia, and the initial ECG shown above. This case provides an excellent example of a “pseudo-infarction” ECG produced by a hyperthermia-induced Brugada-1 ECG pattern. Circulation, 117, 1890–1893. [3]:

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ToxCard: Anticholinergic Plant Toxicity

EMDocs

3-6 Clinical Presentation: Symptoms include altered mental status, tachycardia, hyperthermia, urinary retention, mydriasis, blurred vision, dry skin, hallucinations. Anticholinergic toxicity has overlap with other toxicological causes of hyperthermia which are reviewed here: Hyperthermia in the Toxicological Setting.

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The Latest in Critical Care, 1/22/24 (Issue #26)

PulmCCM

Background Therapeutic hypothermia, later rebranded as targeted temperature management, became a standard post-cardiac arrest therapy for comatose patients after two 2002 NEJM trials ( n=273 and n=77 ) suggested reducing core temperature to 32°C to 34°C markedly improved neurologic outcomes and survival. Read on for details.

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SGEM#336: You Can’t Always Get What You Want – TTM2 Trial

The Skeptics' Guide to EM

Hypothermia versus Normothermia after Out-of-Hospital Cardiac Arrest. Hypothermia versus Normothermia after Out-of-Hospital Cardiac Arrest. Background: Hypothermia has been a mainstay of post-arrest care after the publication of two trials in 2002 that both suggested a benefit. This gives a NNT of 4.

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The Science on Targeted Temperature Management

ACEP Now

Early work on TTM in 2002 showed benefit to cooling to 33 degrees Celsius, which subsequently influenced international resuscitation guidelines to recommend mild hypothermia at 32 degrees to 34 degrees Celsius in 2005. Adding nuance, this study also showed that the highest-severity arrests did not benefit from hypothermia.