Pediatric EM Morsels

AUGUST 9, 2024

We have previously discussed hypothermia presentations , GBS infections , and HSV infections. 2019, there were 1,875 and this trend has continued to increase (2,157 case in 2020; 2,855 cases in 2021). If not treated early, then increased risk of poor outcomes and death. Rates of congenital syphilis are increasing.

Hyperthermia / Hypothermia 152

Hyperthermia / Hypothermia Emergency Department Seizures Pediatrics 152

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.

Hyperthermia / Hypothermia 52

Hyperthermia / Hypothermia Outcomes Hospitals Stroke 52

EMDocs

NOVEMBER 13, 2024

Older age, recurrent episodes of SBP, hepatorenal syndrome, hepatic encephalopathy, acute kidney injury (AKI), concurrent GI bleeding, and higher MELD scores are predictors of worse outcomes. Mild hypothermia is normal in patients with advanced cirrhosis; consider lowering threshold for fever to 37.8 2019 Jan 14;11:13-22.

Hyperthermia / Hypothermia 79

Hyperthermia / Hypothermia Ultrasounds Shock Hospitals 79

Don't Forget the Bubbles

JANUARY 24, 2024

Mortality is high, between 16-43.5% , and neurological outcomes are generally poor amongst survivors. These poor outcomes are related to both the SRSE itself and as a result of the prolonged PICU stay. One study suggests remission in 6 out of 7 patients where it was used, but long-term clinical outcomes remained poor.

Seizures 111

Seizures Pediatrics Outcomes Hyperthermia / Hypothermia 111

ACEP Now

APRIL 3, 2024

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. degrees Celsius. 5,6 In 2021, the TTM2 trial was published. degrees Celsius for 72 hours.

Hyperthermia / Hypothermia 40

Hyperthermia / Hypothermia Resuscitation Outcomes Hospitals 40

The Skeptics' Guide to EM

MARCH 2, 2019

Date: February 26th, 2019 Reference: Benger et al. Tracheal Intubation During Out-of-Hospital Cardiac Arrest on Functional Outcome. Date: February 26th, 2019 Reference: Benger et al. Tracheal Intubation During Out-of-Hospital Cardiac Arrest on Functional Outcome. Effect of a Strategy of a Supraglottic Airway Device
vs.

Airway Management 52

Airway Management CPR Hyperthermia / Hypothermia Outcomes 52

RebelEM

MARCH 30, 2023

Background: Previous observational studies published in 2015 (Geri 2015)(Vyas 2015) indicated that early cardiac catheterization in patients with out-of-hospital cardiac arrest (OHCA) might improve mortality and result in more favorable neurological outcomes. Article: How-Berlemont C, Lamhaut L, Diehl J, et al. 1.15; P= 0.32 1.15; P= 0.31

Hospitals 60

Hospitals Outcomes EKG/ECG Resuscitation 60

Don't Forget the Bubbles

JUNE 30, 2023

The primary outcome measure was chest drain failure, i.e., retained haemothorax requiring a secondary interventional procedure. They stratified patients according to the ratio of FFP: PRBC received (1:1, 1:2, 1:3 and 1:3+) and performed logistic regression analyses for various outcomes. 2019 Aug;31(4):683-687. J Pediatr Surg.

Resuscitation 139

Resuscitation Operations Sepsis Pediatrics 139

Mind The Bleep

OCTOBER 29, 2024

Exposure Expose the patient in a systematic manner while keeping remaining body areas covered e.g. 1 limb at a time, to reduce the risk of hypothermia. Proper stabilization and detailed communication with the burns centre are essential for optimal patient outcomes. 2019 Nov;34(4):276-281. Epub 2019 Nov 29. J Med Toxicol.

Burns 52

Burns Fluid Resuscitation PPE Resuscitation 52

EMDocs

JUNE 27, 2024

2019 Jan 24;14:263-292. Intravenous fluid therapy and hospital outcomes for vaso-occlusive episodes in children, adolescents, and young adults with sickle cell disease. Factors associated with adverse outcome among children with sickle cell disease admitted to the pediatric intensive care unit: an observational cohort.

Pediatrics 76

Pediatrics Dehydration EMS Hospitals 76

Pediatric Education

SEPTEMBER 3, 2023

Other states which could also affect sickling would be dehydration, acidosis, hypoxia and hyperthermia. High-quality studies in the SCT population are needed to clarify the health-outcomes as many studies are necessarily smaller or not able to be performed as rigorously. Clinical Outcomes Associated With Sickle Cell Trait.

Dehydration 40

Dehydration Hyperthermia / Hypothermia Pediatrics Military 40

Northwestern EM Blog

JANUARY 24, 2022

However, even subclinical hypothyroidism with an elevated TSH but normal T4 increases risk of poor outcomes due to effects on cardiac function. By running through this list of alternate causes of refractory shock, other methods of resuscitation can be added to improve patient outcomes and stabilize the patient. 2010; 36: 2019-2029.

Anaphylaxis 52

Anaphylaxis Shock Sepsis Resuscitation 52

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 68

Hyperthermia / Hypothermia EMS Stroke Seizures 68

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 definitions used for each level of evidence are as follows: An update was published by Fanaroff et al in JAMA 2019.

Hyperthermia / Hypothermia 40

Hyperthermia / Hypothermia Research Pediatrics Outcomes 40

EB Medicine

AUGUST 1, 2018

Nachi: Among metabolic abnormalities, patients can present with hyperthermia, hypoglycemia, hypokalemia, hyponatremia, and metabolic acidosis. An RCT is underway in Canada on the use of ondansetron versus haloperidol with an estimated completion of July 2019. Chronic use has also been linked to severe periodontitis.

Seizures 40

Seizures Hyperthermia / Hypothermia Administration Dehydration 40

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 The neuroleptic malignant syndrome-a systematic case series analysis focusing on therapy regimes and outcome. 2019; 44(2): 327-334. Acta Psychiatr Scand. 2020 Sep;142(3):233-241.

Hyperthermia / Hypothermia 96

Hyperthermia / Hypothermia Dehydration Psychiatric Poisoning 96