Remove Administration Remove Hyperthermia / Hypothermia Remove Outcomes
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Neurogenic Shock in Children

Pediatric EM Morsels

Shunting of blood to the extremities results in thermal dysregulation and subsequent hypothermia. Crystalloid may help, but neurogenic shock may not respond to fluid administration. Unopposed vagal tone leads to bradycardia. Alpha 1 agonists are necessary to maintain appropriate blood pressure. J Pediatr Surg. 2001;36(2):373.

Shock 304
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emDOCs Podcast – Episode 102: Hypocalcemia in Trauma and the Diamond of Death

EMDocs

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.

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Hypothermic Cardiac Arrest: Pearls and Pitfalls

EMDocs

Patients can have excellent outcomes despite prolonged resuscitation. Some authors recommend not starting chest compressions in hypothermia unless there is no organized cardiac activity (e.g., 2 In reality you may start compressions before you confirm that hypothermia was the primary cause of cardiac arrest.

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Rethinking the Role of TXA: Are We Asking Too Much?

RebelEM

This balance is upset in trauma by loss of blood and factors, acidosis, hypothermia and the inflammatory cascade. PMID: 37314244 Clinical Question: In advanced trauma systems, does prehospital administration of TXA increase the rate of survival with a favorable neurologic outcome in patients at risk for trauma-induced coagulopathy?

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Major Trauma – Injuries by Assault

Don't Forget the Bubbles

There is significant evidence in adults and developing in the paediatric population that TXA results in better outcomes if given early in patients with mild to moderate traumatic brain injury (TBI) and does not cause harm. What GCS would the administration be recommended for? These should be given as boluses of 5-10ml/kg.

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SGEM#320: The RAMPED Trial – It’s a Gas, Gas, Gas

The Skeptics' Guide to EM

Rapid Administration of Methoxyflurane to Patients in the Emergency Department (RAMPED): A Randomised controlled trial of Methoxyflurane vs Standard care. […] The post SGEM#320: The RAMPED Trial – It’s a Gas, Gas, Gas first appeared on The Skeptics Guide to Emergency Medicine. Reference: Brichko et al. Reference: Brichko et al. AEM Feb 2021.

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Brain Trauma Guidelines for Emergency Medicine

ACEP Now

These guidelines present the best available evidence to support clinical decision making in the prehospital setting when TBI care may have the most significant impact on outcomes; they also establish a research agenda for future investigations. This document is an update of guidelines first published in 2000, and then updated in 2007.