The Skeptics' Guide to EM

MAY 20, 2023

Date: May 10, 2023 Reference: Harhay MO, et al. She is part of the Don’t Forget the Bubbles team and faculty at Queen Mary […] The post SGEM #404: Sitting on the Dock of the Bay-esian Interpretation of Therapeutic Hypothermia for Pediatric Cardiac Arrest first appeared on The Skeptics Guide to Emergency Medicine. NEJM Evidence.

Hyperthermia / Hypothermia 52

Hyperthermia / Hypothermia Pediatrics CPR Hospitals 52

Don't Forget the Bubbles

FEBRUARY 5, 2025

This should include early identification of life-threatening injuries, targeted fluid resuscitation using blood products, pain management, then eventual safeguarding and psychological support. Establish IV access for potential fluid resuscitation. You feel the patient needs fluid resuscitation. Administer O2 if necessary.

Fluid Resuscitation 59

Fluid Resuscitation Domestic Violence Head Injuries Sexual Assault 59

Mind The Bleep

OCTOBER 29, 2024

Establish IV access and begin fluid resuscitation with 250ml boluses of 0.9% 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. This includes adequate pain control, fluid resuscitation, and stabilization of any systemic complications.

Burns 52

Burns Fluid Resuscitation PPE Resuscitation 52

PulmCCM

JANUARY 22, 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 80

Hyperthermia / Hypothermia Outcomes Research Hospitals 80

Don't Forget the Bubbles

JUNE 30, 2023

In addition, a flimsy cannula is easily dislodged during ongoing resuscitation and easily clots off. This was a randomised controlled multisite study comparing resuscitation of trauma patients requiring massive transfusion using either 1:1::1 or 1:1:2 ratios of platelets to plasma to red blood cells. to −0.5%]; P  = 0.03.).

Resuscitation 139

Resuscitation Operations Sepsis Pediatrics 139

RebelEM

JUNE 19, 2023

This balance is upset in trauma by loss of blood and factors, acidosis, hypothermia and the inflammatory cascade. We should expect TXA to help in immediate stabilization and allow trauma teams the time to intervene (whether that be continued resuscitation, interventional or operative procedures).

Blood Transfusions 105

Blood Transfusions Outcomes Administration Hyperthermia / Hypothermia 105

PulmCCM

JANUARY 29, 2024

AHA Updates its Cardiac Arrest Guidelines In December 2023, the American Heart Association published a “focused update” to its landmark guidelines for the management of cardiac arrest. Patients presenting with hypothermia should not be warmed too quickly (allowing their temperature to increase by <0.5°C/hour).

Seizures 115

Seizures CPR Documentation/Coding Hyperthermia / Hypothermia 115

ACEP Now

OCTOBER 3, 2023

In April 2023, the third edition of the Brain Trauma Foundation’s evidence-based guidelines for the prehospital management of traumatic brain injury (TBI) was published in Prehospital Emergency Care. 1 The practice guidelines were written by a multi-disciplinary group of experts and went through an extensive peer review process.

Fluid Resuscitation 98

Fluid Resuscitation Documentation/Coding Resuscitation EMS 98

ACEP Now

APRIL 3, 2024

Targeted temperature management (TTM) for patients following cardiac arrest resuscitation has gone through several dosing iterations in the past two decades. Finally, the guidelines support active temperature management’s (though not necessarily hypothermia) role in improving post-arrest outcomes. degrees Celsius. Click to enlarge.

Hyperthermia / Hypothermia 40

Hyperthermia / Hypothermia Resuscitation Outcomes Hospitals 40

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 Once the patient arrives in your emergency department, a rapid review of the patient’s status and results of resuscitative efforts should be performed. Fluid resuscitation will likely be warranted, and with crystalloid solution is most appropriate. 2023 Jun 14;49(1):74. 4 Another study cited only 2.3 Ital J Pediatr.

Pediatrics 52

Pediatrics Hyperthermia / Hypothermia Emergency Department Resuscitation 52

Mind The Bleep

OCTOBER 17, 2024

Clinically, your enthusiasm for providing maximal quality care needs balanced against rescue practicalities and a hostile environment (very different to your warm, dry resuscitation bay) – the cold makes all veins disappear…and you may be the only clinician responder at the scene. What illnesses or injuries do we see?

Soft Tissue Injuries 52

Soft Tissue Injuries Seizures Ambulance Services Teamwork 52

Don't Forget the Bubbles

AUGUST 12, 2024

After a traumatic brain injury, all children and young people should have a C-ABCDE rapid assessment for life-threatening injuries (as per ATLS guidelines) focussed on trauma resuscitation and stabilisation, followed by a secondary assessment. Published 2023 Feb 23. Doi:10.3389/fncel.2019.00528 Front Neurosci. 2023;17:1090672.

Seizures 75

Seizures Pediatrics Emergency Department Ambulance Services 75

Thinking Critical Care

MAY 18, 2023

This hypovolaemic shock state was to be maintained for one or two hours before the shed blood was retransfused and the effect of experimental drugs on resuscitation could be tested. [11] I do not recall one experiment getting as far as the resuscitation stage. The reason became clear. 10.1016/j.jcrc.2023.154317 311:1137-43. 75:654-663.

Shock 40

Shock Research Sepsis Resuscitation 40

EMDocs

DECEMBER 16, 2023

Evaporative cooling is the preferred method to actively reduce body temperature in the emergency department , as it can be performed with ongoing resuscitation efforts. 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?

Hyperthermia / Hypothermia 94

Hyperthermia / Hypothermia EMS Stroke Seizures 94

Taming the SRU

APRIL 26, 2023

First aid cooling techniques for heat stroke and exertional hyperthermia: A systematic review and meta-analysis. Resuscitation 2020. April 26, 2023) Acute Hyperthermia in the Emergency Department. Thyroid storm: an updated review. J Intensive Care Med 2015. Douma MJ, Aves T, Allan KS, et al. Druyan A, Janovich R, Heled Y.

Hyperthermia / Hypothermia 52

Hyperthermia / Hypothermia Emergency Department Stroke Sepsis 52

Intensive Blog

FEBRUARY 9, 2023

It refers to hypernatraemia, hyperventilation, haemodialysis, and induced hypothermia. Hypothermia Aiming for a lower core temp (35 o C) reduces cerebral metabolic rate and cerebral blood flow. Available from URL: [link] [Accessed 10 February 2023] Death Cap – Amanita phalloides. link] [Accessed 10 February 2023] Yartsev, A.

Poisoning 52

Poisoning Hyperthermia / Hypothermia Fluid Resuscitation Resuscitation 52

Dr. Smith's ECG Blog

MAY 23, 2022

ERS ( E arly R epolarization " S yndrome" ) in which early repolarization ECG findings are seen in a patient with a history of PMVT ( P oly M orphic VT ) or resuscitated idiopathic VT/VFib. The CHALLENGE: In 2008 Hassaguerre found an increased prevalence of ER in patients with idiopathic VFib ( N Engl J Med 358:2016-2023, 2008 ).

EKG/ECG 52

EKG/ECG Documentation/Coding Hyperthermia / Hypothermia Research 52

EMDocs

JUNE 27, 2024

Epub 2023 Nov 27. 2023 Apr;98(4):620-627. Epub 2023 Feb 6. -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 C or 100.4

Pediatrics 97

Pediatrics Dehydration EMS Hospitals 97

Dr. Smith's ECG Blog

JANUARY 21, 2023

In the resuscitation room, the patient had another seizure that stopped after IV Lorazepam. 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).

Hyperthermia / Hypothermia 52

Hyperthermia / Hypothermia EKG/ECG Seizures Fractures 52

Don't Forget the Bubbles

OCTOBER 2, 2024

Original clinical studies Prevention of NICU Admission Hypothermia in Moderate- and Late-Preterm Infants. Trends in HIE and Use of Hypothermia in California: Opportunities for Improvement. 2024 Sep 19:archdischild-2023-326507. 2024 Sep 17:archdischild-2023-326556. Pecenka C, et al. 2024 Sep 21;404(10458):1157-1170.

Pediatrics 52

Pediatrics Hyperthermia / Hypothermia Emergency Department Urgent Care 52

Don't Forget the Bubbles

NOVEMBER 18, 2024

Hypothermia: Newborns, particularly preterm infants, are prone to hypothermia. Before considering fluid resuscitation or inotropes, it is essential to correct the infant’s body temperature. “Epidemiology of Hypotension in Neonates,” Journal of Perinatology , 2023. and Roberts, N. Batton, B.,

Sepsis 59

Sepsis Shock Hyperthermia / Hypothermia Administration 59

Don't Forget the Bubbles

JANUARY 6, 2025

Yasuda M, Amagasa S, Kashiura M, et alDuration of prehospital and in-hospital cardiopulmonary resuscitation and neurological outcome in paediatric out-of-hospital cardiac arrestEmergency Medicine Journal 2024;41:742-748. However, there is limited evidence to guide decisions on when to stop resuscitation efforts in this population.

Dislocations 59

Dislocations CPR Ultrasounds Resuscitation 59

EMDocs

JANUARY 6, 2025

1 By the end of 2023, 117.3 4,5 Of particular concern is the Sudanese conflict, which began in April 2023, and which has caused the largest internal displacement of a population in documented history. 43% of refugees admitted into the US in the first 8 months of the 2023 fiscal year were from Africa. Accessed June 11, 2023.

Infectious Diseases 75

Infectious Diseases CDC PPE Rapid Diagnostic Testing 75