This site uses cookies to improve your experience. To help us insure we adhere to various privacy regulations, please select your country/region of residence. If you do not select a country, we will assume you are from the United States. Select your Cookie Settings or view our Privacy Policy and Terms of Use.
Cookie Settings
Cookies and similar technologies are used on this website for proper function of the website, for tracking performance analytics and for marketing purposes. We and some of our third-party providers may use cookie data for various purposes. Please review the cookie settings below and choose your preference.
Used for the proper function of the website
Used for monitoring website traffic and interactions
Cookie Settings
Cookies and similar technologies are used on this website for proper function of the website, for tracking performance analytics and for marketing purposes. We and some of our third-party providers may use cookie data for various purposes. Please review the cookie settings below and choose your preference.
Strictly Necessary: Used for the proper function of the website
Performance/Analytics: Used for monitoring website traffic and interactions
A 36-year-old male presents to the emergencydepartment after being found down at home by his spouse. This series provides evidence-based updates to previous posts so you can stay current with what you need to know. Per the mans wife, the patient is a heavy drinker often consuming two to three pints of vodka daily.
This week we cover the POLAR RCT on hypothermia for neuroprotection in those with severe TBI. Take Aways: The data do not suggest that targeted hypothermia improves neurological function, reduces death, or reduces hospital length of stay as compared to normothermia. Welcome back to the “52 in 52” series. Bradycardia: 18.8%
Louis) // Reviewed by: Alex Koyfman, MD (@EMHighAK); Brit Long, MD (@long_brit) Case You are working in the trauma/critical care pod of your emergencydepartment (ED). You receive a page for a cardiac arrest and take report from emergency medical services (EMS). Classification of hypothermia.
Neonates presenting to the EmergencyDepartment often cause a lot of uncertainty. We have previously discussed hypothermia presentations , GBS infections , and HSV infections. If not treated early, then increased risk of poor outcomes and death. Is this scalp swelling normal? Is this bloody stool concerning?
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. Emerg Med J. 2011;70(2):391-397.
Laura Melville (@lmelville535) is an emergency physician in Brooklyn, New York, is a part of the New York ACEP Research Committee, ALL NYC EM, and is the NYP-Brooklyn Methodist Resident Research Director. Case: A 59-year-old woman comes is brought into your emergencydepartment (ED) by EMS in cardiac arrest.
Induced hypothermia after cardiac arrest is also called “active temperature control” or “targeted temperature management.” TTM2 found no improvement in survival or neurologic outcome among patients randomized to cooling to a target of 33 °C, as compared to controls receiving fever prevention (e.g.
Kat Priddis is a paediatric emergency medicine consultant and trauma director at Watford General Hospital. She is part of the Don’t Forget the Bubbles team and faculty at Queen Mary University in London where she teaches part of the Paediatric Emergency Medicine MSc. Date: May 10, 2023 Reference: Harhay MO, et al. N Engl J Med.
Hypothermia for Neuroprotection in Convulsive Status Epilepticus. NEJM Dec 2016 Guest Skeptic: Dr. Neal Little is an Emergency Physician who works at Chelsea Hospital in Chelsea, Michigan. He is also a Faculty member of the Emergency Medicine and Acute Care Series 1986 to present. He is known to have poorly controlled epilepsy.
1,2 Clinical outcomes in submersion injuries are largely dependent on the degree of hypoxic injury experienced by the victim, making prehospital care of paramount importance. Optimally, bystander CPR, including the administration of rescue breaths, should be initiated prior to arrival of emergency medical services. pediatric hospitals.
Rapid Administration of Methoxyflurane to Patients in the EmergencyDepartment (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.
The Annals of Emergency Medicine Podcast continues apace, with free monthly updates from the original research published in the journal: iTunes Link SoundCloud Link Likewise, the Annals of Emergency Medicine Journal Club has published several monthly installments: Predicting Outcomes in Pediatric Pneumonia: Are We Omnipotent or Incompetent?
Tracheal Intubation During Out-of-Hospital Cardiac Arrest on Functional Outcome. Tracheal Intubation During Out-of-Hospital Cardiac Arrest on Functional Outcome. Case: EMS arrive to your emergencydepartment with a 68-year-old man post cardiac arrest patient. Date: February 26th, 2019 Reference: Benger et al.
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. His heart rate is creeping up, now 140.
Vaishnav Hyperthermia: abnormally high body temperature due to thermoregulatory failure Severe hyperthermia: temp greater than 40.5C stent, percutaneous nephrostomy) by urology or IR Hypokalemia evaluate for EKG changes assess for underlying cause and factors that may influence ability to replete (i.e.
Circulation 2020 Guest Skeptic: Missy Carter is a PA practicing in emergency medicine in the Seattle area and an adjunct faculty member with the Tacoma Community College paramedic program. The key result was that significantly fewer patients had a favorable neurologic outcome in the IO group compared to the IV group.
A retrospective evaluation of phenobarbital versus benzodiazepines for the treatment of alcohol withdrawal in a regional Canadian emergencydepartment Link: [link] Bottom Line: This study in a small regional ED showed a QI project rolling out a Phenobarbital or Diazepam for Alchohol withdrawal syndrome. and NPV(50%).
JAMA 2020 Guest Skeptic: Mike Carter is a former paramedic and current PA practicing in pulmonary and critical care as well as an adjunct professor of emergency medical services at Tacoma Community College. Case: During a busy emergencydepartment (ED) shift the paramedic phone rings.
Early Antibiotic Use and Neonatal Outcomes Among Preterm Infants Without Infections. Invasive bacterial infection in children with fever and petechial rash in the emergencydepartment: a national prospective observational study. Eur J Pediatr. 2023 Apr 13. Patterns of parental online health information-seeking behaviour.
Let’s take the humble blood transfusion – used in emergencydepartments across the globe and playing a key role in critical care. Some wonder if giving blood to children with a haemoglobin <6g/dl will improve outcomes. Outcomes Primary outcome Mortality at 28 days after randomisation. Was blinding achieved?
The fragility index of these findings found to be 1 for VC and 9 for DED Obtaining a second defibrillator in the emergencydepartment or intensive care unit can be very easy to do. Within the United States, due to paramedic shortages, this dual-medic setup does not exist in many EMS systems.
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. Intensive Care Medicine.
An 18-month-old boy presents to the emergencydepartment with loss of consciousness. Evaporative cooling is the preferred method to actively reduce body temperature in the emergencydepartment , as it can be performed with ongoing resuscitation efforts. 1 Fever is usually < 40C. 1 Fever is usually < 40C.
doi: 10.1136/archdischild-2024-327224 Six-year-old Rhaenyra is brought into the emergencydepartment after being hit by a car. In adults, TXA has been shown to reduce transfusion requirements and improve outcomes. Although TXA improved outcomes in combat settings, it did not significantly improve survival in civilian settings.
Intravenous fluid therapy and hospital outcomes for vaso-occlusive episodes in children, adolescents, and young adults with sickle cell disease. Intranasal fentanyl and discharge from the emergencydepartment among children with sickle cell disease and vaso-occlusive pain: A multicenter pediatric emergency medicine perspective.
Morris and colleagues investigated the efficacy of refrigerated gel packs for therapeutic hypothermia in neonatal retrieval. They used servo-controlled therapeutic hypothermia (versus passive hypothermia) and found no major difference in outcome. More studies on this topic will surely follow. Gallo Ruelas M, et al.
No drug or combination improved the primary outcome (a composite outcome of hypoxemia, visit to the emergencydepartment, hospitalization, or death). Sepsis was a main trigger, and hypothermia and shock were as common (>50%) as coma. That was in NEJM Aug 18 2022. and FT4 (0-7.8
So fever or hypothermia, extreme tachycardia, tachypnea, altered consciousness, a very unwell appearance, or even hypotension. Now, some facilities have a short stay unit, like in their emergencydepartment. Severe cellulitis has severe swelling and tenderness. really affecting function. So what causes it?
Because Dexmed can blunt these responses, they are particularly vulnerable to hypothermia during its use. Dexmedetomidine can be used alongside other sedatives and analgesics to enhance clinical outcomes while minimising the adverse effects of those drugs. Adv Emerg Nurs J. How is Dexmedetomidine administered? Paediatr Anaesth.
then need further evaluation Usually with CTA imaging If normal physical exam & ABI>0.9, million presentation to ED’s throughout the US Usually occur due to falls Also commonly occur due to sports, MVC’s, etc.
Research and guidelines from Australian centres, like those published by the Australian and New Zealand Neonatal Network (ANZNN), emphasize early detection and management to improve outcomes. Hypothermia: Newborns, particularly preterm infants, are prone to hypothermia. After any stressful situation, don’t forget to debrief.
Reviewed by: Mikaeel Jaffer Article 2: Does the duration of pre-hospital CPR affect neurological outcomes? 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.
We organize all of the trending information in your field so you don't have to. Join 5,000+ users and stay up to date on the latest articles your peers are reading.
You know about us, now we want to get to know you!
Let's personalize your content
Let's get even more personalized
We recognize your account from another site in our network, please click 'Send Email' below to continue with verifying your account and setting a password.
Let's personalize your content