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 57

Hospitals Outcomes EKG/ECG Resuscitation 57

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. These cases illustrate some of the common issues associated with each shunt type, but what does the evidence say about outcomes? 2014;129(20):2013-2020. 2018;37(7):879-885.

Operations 128

Operations Research Hyperthermia / Hypothermia Hospitals 128

Don't Forget the Bubbles

JANUARY 10, 2024

Some wonder if giving blood to children with a haemoglobin <6g/dl will improve outcomes. Outcomes Primary outcome Mortality at 28 days after randomisation. The authors chose a patient-centred, primary outcome in keeping with their pragmatic design. What were the research questions? The study asked TWO questions: 1.

Blood Transfusions 78

Blood Transfusions Research Outcomes Hospitals 78

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. Assess pupillary reaction to light. Acute Crit Care. doi: 10.4266/acc.2019.00647.

Burns 52

Burns Fluid Resuscitation PPE Resuscitation 52

Thinking Critical Care

MAY 18, 2023

Richard was constructing a relational database of severity of illness scores and intensive care outcome at WIG. We did not achieve a publishable consensus until 2020. 14] N Engl J Med 2008; 358:111-124 DOI: 10.1056/NEJMoa071366 15 Anaesthesia 2020 May. The Shock Team had an office with three desks, one for each of us.

Shock 40

Shock Research Sepsis Resuscitation 40

EMDocs

JUNE 12, 2024

Previous triad of death = hypothermia, acidosis, and coagulopathy. HypoCa is common in trauma patients and is associated with poor outcomes. Liver dysfunction, secondary cirrhosis, critical illness, trauma, and hypothermia reduce citrate metabolism. Hypothermia also leads to hypoCa. Whole blood does contain less citrate.

Hyperthermia / Hypothermia 100

Hyperthermia / Hypothermia Resuscitation Administration Blood Transfusions 100

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 2020 Sep-Oct;19(5):451-457.

Hyperthermia / Hypothermia 99

Hyperthermia / Hypothermia Ultrasounds Shock Hospitals 99

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

EMDocs

JUNE 27, 2024

2020 Feb 12;10(1):2470. 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 88

Pediatrics Dehydration EMS Hospitals 88

RebelEM

DECEMBER 19, 2022

That write up was for the DOSE-VF pilot trial done in March 2020 and can be found here. At REBEL EM, we’ve done an extensive write up that details some of the different types of DED and the electrophysiology behind it. Now that same group has published the results of their full randomized control trial.

EMS 52

EMS CPR Shock 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 80

Hyperthermia / Hypothermia EMS Stroke Seizures 80

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. 2020 Sep;142(3):233-241. Epub 2020 Aug 2. Acta Psychiatr Scand.

Hyperthermia / Hypothermia 97

Hyperthermia / Hypothermia Dehydration Psychiatric Poisoning 97

Don't Forget the Bubbles

JANUARY 2, 2025

As our highlights may show A study in JAMA Pediatrics assessed the impact of foetal major congenital heart defects (MCHDs) on the risk of adverse obstetric outcomes. Original clinical studies Changes in Patent Ductus Arteriosus Management and Outcomes in Infants Born at 26 to 28 Weeks’ Gestation. Eur J Pediatr. Butler V, et al.

Pediatrics 59

Pediatrics Ultrasounds Ethical Issues Hospitals 59