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emDOCs Revamp: Alcohol Withdrawal

EMDocs

2016; 83(1): 67-79. fold higher risk of NSTI than the control group 12 For those without comorbidities , AUD exhibited a 15.2-fold fold higher risk of NSTI than the control group 12 For those without comorbidities , AUD exhibited a 15.2-fold Management of drug and alcohol withdrawal. N Engl JMed. 2003; 348:1786-1795. Cleve Clin J Med.

Seizures 105
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ToxCard: Second Generation Antipsychotic Overdose

EMDocs

1,2 Neuroleptic malignant syndrome (NMS) (hyperthermia, autonomic instability, rigidity, altered mental status [AMS]) can occur as well and is most often seen with clozapine but has been observed with other atypicals. Rigidity and hyperthermia should raise concerns for NMS. 2016 Dec;54(10):899-923. Clin Toxicol (Phila).

Poisoning 111
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emDOCs Podcast – Episode 110: Primary Spontaneous Bacterial Peritonitis

EMDocs

Mild hypothermia is normal in patients with advanced cirrhosis; consider lowering threshold for fever to 37.8 Marked hypothermia is specific for SBP (> 90%), and it’s a poor prognostic finding. 2016; 63:1299-1309. Approximately 50% have altered mental status, but it may be subtle. Piano S, Fasolato S, Salinas F, 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. Heart Rhythm, 13(7): 1515-1520. [2]:

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SGEM#199: Therapeutic Hypothermia – What is it Good For?

The Skeptics' Guide to EM

Hypothermia for Neuroprotection in Convulsive Status Epilepticus. NEJM Dec 2016 Guest Skeptic: Dr. Neal Little is an Emergency Physician who works at Chelsea Hospital in Chelsea, Michigan. Case: Johnny is a […] The post SGEM#199: Therapeutic Hypothermia – What is it Good For? Reference: Legriel et al.

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SGEM#183: Don’t RINSE, Don’t Repeat

The Skeptics' Guide to EM

Induction of Therapeutic Hypothermia During Out-of-Hospital Cardiac Arrest Using a Rapid Infusion of Cold Saline
The RINSE Trial (Rapid Infusion of Cold Normal Saline). Circulation 2016. Circulation 2016. Background: Therapeutic hypothermia post cardiac arrest has received a great deal of attention since 2002.

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An elderly male with acute altered mental status and huge ST Elevation

Dr. Smith's ECG Blog

2016 Nov;34(11):2182-2185. Epub 2016 Aug 27. Although commonly associated with hypothermia — other conditions have also been associated with Osborn waves, including CNS disorders and severe cardiac ischemia ( potentially relevant considerations — given the impaired mental status and the ST elevation in today's case ).

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