The Skeptics' Guide to EM

SEPTEMBER 29, 2018

[display_podcast] Date: September 21st, 2018 Reference: Kawano et al. Annals of EM May 2018 Guest Skeptic: Andrew Merelman is a critical care paramedic and first year medical student at Rocky Vista University in Colorado. display_podcast] Date: September 21st, 2018 Reference: Kawano et al.

Basic Life Support 52

Basic Life Support Airway Management CPR Resuscitation 52

Don't Forget the Bubbles

JANUARY 24, 2024

2018 May 17;378(20):1888-1897. 2018 Dec;84(6):940-945. Epub 2018 Nov 30. Hypothermia for Neuroprotection in Convulsive Status Epilepticus. Devinsky O, Patel AD, Cross JH, Villanueva V, Wirrell EC, Privitera M, Greenwood SM, Roberts C, Checketts D, VanLandingham KE, Zuberi SM; GWPCARE3 Study Group. N Engl J Med.

Seizures 111

Seizures Pediatrics Outcomes Hyperthermia / Hypothermia 111

Dr. Smith's ECG Blog

JULY 22, 2023

This discussion comes from this previous post: Hyperthermia and ST Elevation Discussion Brugada Type 1 ECG changes are associated with sudden cardiac death (SCD) and the occurrence of ventricular dysrhythmias. Syncope and weakness were attributed to acute illness from influenza. The patient did well and was ultimately discharged home.

EKG/ECG 92

EKG/ECG Hyperthermia / Hypothermia Documentation/Coding Administration 92

The Skeptics' Guide to EM

MARCH 2, 2019

JAMA 2018 Guest Skeptic: Missy Carter, former City of Bremerton Firefighter/Paramedic, currently a physician assistant practicing in emergency medicine in the Seattle area and an adjunct faculty […] The post SGEM#247: Supraglottic Airways Gonna Save You for an OHCA? JAMA 2018 * Population: Adults who had a non-traumatic OCHA.

Airway Management 52

Airway Management CPR Hyperthermia / Hypothermia Outcomes 52

EMDocs

JUNE 25, 2024

Severely burned patients have impaired thermoregulation and are at risk of hypothermia. National Burn Repository 2019 Update, Report of data from 2009–2018. No role for prophylactic antibiotics in burn and inhalation injuries. May increase the risk of fungal infections and resistant organism. References American Burn Association.

Burns 92

Burns Fluid Resuscitation Resuscitation Poisoning 92

Broome Docs

OCTOBER 31, 2022

2018 Sep 11;362:k3843. PMID: 36168956 Bottom line: Despite the significant imperfections of this trial, it is important data (as we lack data on hypothermia after inpatient cardiac arrest), and it adds to the growing body of evidence that suggests hypothermia provides no benefit. Lancet Neurol. 2022 Sep;21(9):781-791.

Hyperthermia / Hypothermia 52

Hyperthermia / Hypothermia Fluid Resuscitation Seizures Emergency Department 52

Dr. Smith's ECG Blog

FEBRUARY 16, 2020

had at least 2 potential etiologies for developing acute myocarditis: i ) Profound hypothermia ( core temperature = 90°F = 32.2°C Smith — this case was not what I thought. I did recognize the S hark F in m orphology of dramatic ST elevation. C ) ; and , ii ) She tested positive for influenza. Our THANKS to Dr.

Shock 52

Shock Hyperthermia / Hypothermia EKG/ECG Hospitals 52

The Skeptics' Guide to EM

AUGUST 14, 2021

This has included the classic paper from Legend of EM Dr. Ian Stiell on BLS vs. ACLS ( SGEM#64 ), the use of mechanical CPR ( SGEM#136 ), and pre-hospital hypothermia ( SGEM#183 ). This was a critical appraisal of an observational study published in Annals of EM ( Kawano et al 2018 ).

Shock 52

Shock CPR Hyperthermia / Hypothermia EMS 52

Pediatric Education

SEPTEMBER 3, 2023

Other states which could also affect sickling would be dehydration, acidosis, hypoxia and hyperthermia. doi:10.1182/blood-2018-06-848705 Naik RP, Smith-Whitley K, Hassell KL, et al. A 2019 systematic review of SCT found that there is a risk for pulmonary embolism, proteinuria and chronic kidney disease (high-strength evidence).

Dehydration 40

Dehydration Hyperthermia / Hypothermia Pediatrics Military 40

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. Trauma Surg Acute Care Open.

Resuscitation 139

Resuscitation Operations Sepsis Pediatrics 139

Dr. Smith's ECG Blog

MAY 5, 2022

72; Issue 9; 2018 ) — A ) Brugada-1 ECG pattern, showing coved ST-segment elevation ≥2 mm in ≥1 right precordial lead, followed by a negative T-wave. — 72; Issue 9; 2018. These include ( among others ) — acute febrile illness — variations in autonomic tone — hypothermia — ischemia/infarction/cardiac arrest — and Hyperkalemia.

EKG/ECG 52

EKG/ECG Fluid Resuscitation EMS Shock 52

Don't Forget the Bubbles

FEBRUARY 5, 2025

In the bleeding trauma patient, fluid resuscitation aims to avoid the diamond of death (acidosis, coagulopathy, hypothermia and hypocalcaemia). Don’t Forget the Bubbles, 2018. When blood products are available, evidence suggests using a balanced approach, transfusing a 1:1:1 FFP:platelets:pRBC ratio. General Medical Council.

Domestic Violence 59

Domestic Violence Fluid Resuscitation Head Injuries Sexual Assault 59

Dr. Smith's ECG Blog

MAY 6, 2019

Excerpted from Vutthikraivit et al: Acta Cardiol Sin 34:267-277, 2018 ). == Distinction is made between 2 types of Brugada ECG patterns: A B rugada - 1 ECG pattern — shows ≥2 mm coved ST elevation with sharp downslope plus T wave inversion in ≥2 anterior leads. Hypothermia. Acute febrile illness. Variations in autonomic tone.

EKG/ECG 52

EKG/ECG Hyperthermia / Hypothermia 52

Mind The Bleep

DECEMBER 19, 2023

In cases of hypothermia, re-warming can be done passively (with blankets), or active techniques can be implemented in severe cases. 2018, November ). If fever is present, co-existing infection should be kept as a differential and IV antibiotics should be started as soon as possible. References (2021). Diabetic Ketoacidosis.

Dehydration 98

Dehydration Fluid Resuscitation Shock Resuscitation 98

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. 2018; 44(5): 652-655. 2018; 22(1):215. Sources: 1) Amrein K, Martucci G, and Hahner S. 2008;14:379-83.

Anaphylaxis 52

Anaphylaxis Shock Sepsis Resuscitation 52

Dr. Smith's ECG Blog

NOVEMBER 25, 2022

These include ( among others ) — acute febrile illness — variations in autonomic tone — hypothermia — ischemia-infarction — malignant arrhythmias — cardiac arrest — and especially Hyperkalemia. Patients with such conditions that may transiently mimic the ECG findings of a Brugada-1 pattern are said to have Brugada Phenocopy.

EKG/ECG 52

EKG/ECG Fractures Hyperthermia / Hypothermia Wellness 52

Dr. Smith's ECG Blog

OCTOBER 26, 2020

The patient received therapeutic hypothermia at 33 degrees C for 24 hours. As I “confessed” in the September 26, 2018 post of Dr. Smith’s ECG Blog — my brain is “programmed” to interpreting 12-lead ECGs and rhythm strips at the 25 mm/second speed that is standard in the United States. Troponin T peaked at 330 ng/L, then trended down.

EKG/ECG 40

EKG/ECG Hyperthermia / Hypothermia CPR Wellness 40

EB Medicine

AUGUST 1, 2018

I’m Jeff Nusbaum, and I’m back with my co-host, Nachi Gupta and we’ll be taking you through the August 2018 issue of Emergency Medicine Practice. Nachi: To attain the most up to date information for this article, Dr. Williams searched the PubMed and Cochrane Databases from 1950 to 2018. Jeff: Let’s get started with the pathophysiology.

Seizures 40

Seizures Hyperthermia / Hypothermia Administration Dehydration 40

The Skeptics' Guide to EM

MARCH 5, 2022

This includes therapeutic hypothermia for out-of-hospital cardiac arrest (OHCA), tranexamic acid (TXA) for epistaxis and electrolyte solutions for mild pediatric gastroenteritis. The level of high-quality evidence had not changed much when looking at the ACC/AHA guidelines from 2008-2018.

Hyperthermia / Hypothermia 40

Hyperthermia / Hypothermia Research Pediatrics Outcomes 40

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. Heart Rhythm 2018. Hyperkalemia 2. Other drugs with sodium channel blockade: Tricyclic antidepressants. This would be advisable.

EKG/ECG 52

EKG/ECG Hyperthermia / Hypothermia Seizures Documentation/Coding 52

Dr. Smith's ECG Blog

MAY 23, 2022

NOTE: Early repolarization is included among the "J Wave Syndromes" ( JWS ) which are a phenotypic spectrum of disorders including individuals with ERS, Brugada Syndrome and/or malignant arrhythmias linked to STEMIs or the J-point accentuation ( Osborn wave ) of hypothermia. Suffice it to say Much remains to be learned!

EKG/ECG 52

EKG/ECG Documentation/Coding Hyperthermia / Hypothermia Research 52

RebelEM

DECEMBER 19, 2022

trying harder and longer knowing they are enrolled in this study) Use of two different models of defibrillators may negatively impact the internal validity of this pilot study Certain baseline characteristics were not balanced, such as: prehospital intubation and Epinephrine administration.

EMS 52

EMS CPR Shock Resuscitation 52

EMDocs

JUNE 27, 2024

2018 Aug;46(3):144-151. Epub 2018 Oct 17. -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 0.4 PMID: 35788790.

Pediatrics 94

Pediatrics Dehydration EMS Hospitals 94

Dr. Smith's ECG Blog

JANUARY 13, 2025

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. Hypothermia. Hyperkalemia 2. Other drugs with sodium channel blockade: Tricyclic antidepressants. Ischemia or infarction. Cardiac arrest.

Hyperthermia / Hypothermia 74

Hyperthermia / Hypothermia EKG/ECG Wellness Documentation/Coding 74

Don't Forget the Bubbles

JANUARY 2, 2025

Using data from the Danish Fetal Medicine Database (from 2008 to 2018), it found that pregnancies with MCHDs had a significantly higher rate of complications such as preeclampsia, preterm birth, and foetal growth restriction compared to those without MCHDs (23% versus 9%), except for transposition of the great arteries. El-Naggar W, et al.

Pediatrics 59

Pediatrics Ultrasounds Ethical Issues Hospitals 59

EMDocs

NOVEMBER 6, 2024

Recovery from profound lactic acidosis, hyperthermia, and rhabdomyolysis. tetani infection is also indicated. Clin Toxicol. 1970;3(2):267-273. doi:10.3109/15563657008990475 Boyd RE, Brennan PT, Deng JF, Rochester DF, Spyker DA. Strychnine poisoning. 1983;74(3):507-512. doi:10.1016/0002-9343(83)90999-3 Hardin J, Griggs R. The Lancet.

Poisoning 95

Poisoning Airway Management Dislocations Hyperthermia / Hypothermia 95

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. doi:10.1136/bmjgh-2018-001114 Okesanya OJ, Olatunji GD, Kokori E, et al. BMJ Glob Health.

Infectious Diseases 72

Infectious Diseases CDC PPE Rapid Diagnostic Testing 72