EMDocs
JUNE 1, 2023
This week we cover the POLAR RCT on hypothermia for neuroprotection in those with severe TBI. Take Aways: The data do not suggest that targeted hypothermia improves neurological function, reduces death, or reduces hospital length of stay as compared to normothermia. Welcome back to the “52 in 52” series. Bradycardia: 18.8%
Resus Review
APRIL 6, 2015
Malignant hyperthermia is a life-threatening reaction to volatile anesthetics and the neuromuscular blocking agent succinylcholine. Dantrolene acts at the ryanodine receptor blocking the release of calcium from the sarcoplasmic reticulum, and reducing the intracellular calcium, thereby countering the effects of the malignant hyperthermia.
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PulmCCM
JANUARY 22, 2024
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.
RebelEM
JUNE 19, 2023
This balance is upset in trauma by loss of blood and factors, acidosis, hypothermia and the inflammatory cascade. Lancet 2010; 376(9734): 23-32. Our bodies have a finely tuned system that allows blood to flow freely and not clot too easily while also allowing the body to form clots when needed.
PulmCCM
JANUARY 24, 2024
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.
Don't Forget the Bubbles
JUNE 26, 2023
The JET is treated by deepening sedation (to minimise exogenous and endogenous catecholamines), optimizing electrolytes and active mild hypothermia. The seminal trial addressing this in the Norwood population was The Single Ventricle Reconstruction Trial, published in 2010.
Pediatric Emergency Playbook
MARCH 1, 2016
The Trauma Death Spiral Lethal triad of hypothermia, acidosis, and coagulopathy. Do everything you can to support perfusion and avoid the death spiral of hypothermia, coagulopathy, and acidosis. 2010 Nov;19(4):286-91. Puffer fish or blob: a hyperfibrinolytic tracing. That patient will needs clot-stablizer. Semin Pediatr Surg.
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