Dr. Smith's ECG Blog

OCTOBER 12, 2024

2017 Sep-Oct;50(5):561-569. Epub 2017 Apr 19. 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 ).

EKG/ECG 116

EKG/ECG Documentation/Coding Emergency Department COPD 116

The Skeptics' Guide to EM

JUNE 24, 2017

[display_podcast] Date: June 20th, 2017 Reference: Bernard et al. 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). display_podcast] Date: June 20th, 2017 Reference: Bernard et al. Circulation 2016.

Hyperthermia / Hypothermia 40

Hyperthermia / Hypothermia CPR Resuscitation EMS 40

Don't Forget the Bubbles

JANUARY 24, 2024

2017 May 25;376(21):2011-2020. Hypothermia for Neuroprotection in Convulsive Status Epilepticus. 2017 Sep;82(3):342-352. Epub 2017 Sep 11. Devinsky O, Cross JH, Laux L, Marsh E, Miller I, Nabbout R, Scheffer IE, Thiele EA, Wright S; Cannabidiol in Dravet Syndrome Study Group. N Engl J Med. doi: 10.1056/NEJMoa1611618.

Seizures 111

Seizures Pediatrics Outcomes Hyperthermia / Hypothermia 111

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.

Hyperthermia / Hypothermia 52

Hyperthermia / Hypothermia Outcomes Hospitals Stroke 52

ACEP Now

OCTOBER 11, 2024

3 Hypothermia is commonly encountered in submersion episodes, regardless of geographic location and season, although case reports have hypothesized improved neurologic outcomes, possibly due to the protective effects of the lower body temperatures. 9,11 As with many pediatric issues, prevention is key.

Pediatrics 52

Pediatrics Hyperthermia / Hypothermia Emergency Department Resuscitation 52

Advanced Emergency Nursing from AENJ

MAY 2, 2017

Useful combinations can be made such as near-drowning & hypothermia & intoxication. Consider preparing, or recording them, in a digital format that can be used and shared when personally convenient, that can be a supplement or alternative to traditional staff meetings. Not an impossible likelihood, eh?)

Hyperthermia / Hypothermia 40

Hyperthermia / Hypothermia Emergency Nursing Documentation/Coding Pediatrics 40

RebelEM

MARCH 30, 2023

PMID: 35675081 What They Did: National, multicenter, randomized control, open-label parallel trial performed at 22 centers in FrancePatients enrolled from January 19, 2017 – November 23, 2020. Published online June 08, 2022. Bougouin, W., Varenne, O., Daviaud, F., Lamhaut, L., Chiche, J.-D., Spaulding, C.,

Hospitals 66

Hospitals Outcomes EKG/ECG Resuscitation 66

Taming the SRU

APRIL 17, 2023

Patients typically present with tachycardia, mydriasis hyperthermia, altered mental status, anhidrosis, and urinary retention. 2017 Sep-Dec;21(3):101-104. Their toxic effects are caused by hyoscyamine and scopolamine. These atropine-like alkaloids produce an anticholinergic syndrome when smoked or ingested. J Am Acad Dermatol.

Poisoning 52

Poisoning Hyperthermia / Hypothermia Anaphylaxis Pediatrics 52

Don't Forget the Bubbles

JUNE 30, 2023

Traditionally thought to result from the dilutional effects of massive transfusion, acidaemia or hypothermia, trauma-induced coagulopathy is now known to be triggered at the time of injury, long before these factors have developed or any medical intervention has taken place. 2017 Dec;83(6):1136-1141. Trials 23, 384 (2022).

Resuscitation 139

Resuscitation Operations Sepsis Pediatrics 139

Northwestern EM Blog

JANUARY 24, 2022

While the diagnosis of hypothyroidism can be delayed by lab results, clues to the diagnosis include thyroidectomy scar, non-pitting edema of the extremities, macroglossia, altered mental status, hypoglycemia and hypothermia. 2017; 45(9): 1443-1449. Intensive Care Medicine. 2010; 36: 2019-2029. 7) Manji F, Wierstra B, and Posadas J.

Anaphylaxis 52

Anaphylaxis Shock Sepsis Resuscitation 52

Don't Forget the Bubbles

JANUARY 10, 2024

3,950 children were recruited between September 2014 to May 2017. These were presented as hazard ratios and included fever at presentation, previous transfusion ever, haemoglobinuria, malaria, sickle cell disease on enrolment, HIV, evidence of sepsis, malnutrition, shock, hypothermia, and dehydration. Do you believe the results?

Blood Transfusions 78

Blood Transfusions Research Outcomes Hospitals 78

EMDocs

DECEMBER 16, 2023

Broad-spectrum antibiotics (A) for septic shock are not inappropriate given the hyperthermia, tachycardia, and hypotension. Hyperthermia. As you attempt to examine the patient, he has a generalized, tonic-clonic seizure. What is your diagnosis, and what are your next steps in evaluation and management? 1 Fever is usually < 40C.

Hyperthermia / Hypothermia 94

Hyperthermia / Hypothermia EMS Stroke Seizures 94

Dr. Smith's ECG Blog

DECEMBER 5, 2019

Drug toxicity , especially diphenhydramine , which has sodium channel blocking effects, and also anticholinergic effects which may result in sinus tachycardia, hyperthermia, delirium, and dry skin. This is based on the Sieira et al, 2017, risk calculator , which gives a borderline risk score (2). Hyperkalemia 2.

EKG/ECG 52

EKG/ECG Hyperthermia / Hypothermia Seizures Documentation/Coding 52

Dr. Smith's ECG Blog

JANUARY 21, 2023

Acute and reversible J waves are called "Osborn waves" and are often associated with hypothermia which can also induce ventricular arrhythmias (3), where their size correlates with colder temperatures and resolves with warming (5). Hypothermia can also produce bradycardia and J waves, with a pseudo-STEMI pattern. TSH came back as 45.

Hyperthermia / Hypothermia 52

Hyperthermia / Hypothermia EKG/ECG Seizures Fractures 52

EMDocs

JUNE 27, 2024

2017 Dec 1;30(4):191-201. -smoke, high ozone levels, smog) Asthma/reactive airway disease (RAD) Diagnostic criteria 7,8 Respiratory symptoms +/- fever (at least 38.0 C or 100.4 2 mcg/kg, max 100 mcg) while obtaining IV access 20 IV/IM ketorolac (1 mg/kg, max 15 mg) Morphine (05-0.1 mg/kg, max 4 mg per dose q20-30min) or hydromorphone (0.01-0.02

Pediatrics 97

Pediatrics Dehydration EMS Hospitals 97

Taming the SRU

JANUARY 5, 2025

Specificity: 90.7%) Exposure to a dopamine antagonist or withdrawal of a dopamine agonist in the prior 72 hours: 20 points Hyperthermia (>100.4 2017 Feb;37(1):67-71. mg/kg initially followed by 1mg/kg q6hrs Disposition NMS can be very severe and usually requires ICU level care. Gurrera RJ, Mortillaro G, Velamoor V, Caroff SN.

Hyperthermia / Hypothermia 97

Hyperthermia / Hypothermia Dehydration Psychiatric Poisoning 97

Don't Forget the Bubbles

NOVEMBER 18, 2024

Hypothermia: Newborns, particularly preterm infants, are prone to hypothermia. In these situations, it’s crucial to focus on treating the underlying respiratory issue—ensuring adequate oxygenation and ventilation and possibly using inhaled nitric oxide for pulmonary hypertension—rather than just addressing the low blood pressure.

Sepsis 59

Sepsis Shock Hyperthermia / Hypothermia Administration 59

EMDocs

JANUARY 6, 2025

Signs of malnutrition – which places patients at higher risk for infection – can include cachexia, muscular wasting, sunken eyes, redundant skin folds, edema, brittle skin and hair, bradycardia, hypotension, and hypothermia. Lassa fever: epidemiology, clinical features, and social consequences. 2003;327(7426):1271-1275.

Infectious Diseases 75

Infectious Diseases CDC PPE Rapid Diagnostic Testing 75