The Skeptics' Guide to EM

JUNE 24, 2017

Induction of Therapeutic Hypothermia During Out-of-Hospital Cardiac Arrest Using a Rapid Infusion of Cold Saline
The RINSE Trial (Rapid Infusion of Cold Normal Saline). Induction of Therapeutic Hypothermia During Out-of-Hospital Cardiac Arrest Using a Rapid Infusion of Cold Saline
The RINSE Trial (Rapid Infusion of Cold Normal Saline).

Hyperthermia / Hypothermia 40

Hyperthermia / Hypothermia CPR Resuscitation EMS 40

The Skeptics' Guide to EM

MAY 8, 2021

He is an EMS medical director with Lexington Fire/EMS as well as the AMR/NASCAR […] The post SGEM#329: Will Corticosteroids Help if…I Will Survive a Cardiac Arrest? He is an EMS medical director with Lexington Fire/EMS as well as the AMR/NASCAR Safety Team. first appeared on The Skeptics Guide to Emergency Medicine.

CPR 52

CPR Hyperthermia / Hypothermia EMS Documentation/Coding 52

The Skeptics' Guide to EM

SEPTEMBER 29, 2018

Annals of EM May 2018 Guest Skeptic: Andrew Merelman is a critical care paramedic and first year medical student at Rocky Vista University in Colorado. Annals of EM May 2018 Guest Skeptic: Andrew Merelman is a critical care paramedic and first year medical student at Rocky Vista University in Colorado.

Basic Life Support 52

Basic Life Support Airway Management CPR Resuscitation 52

The Skeptics' Guide to EM

AUGUST 14, 2021

Missy is also now the director for Difficult Airway EMS course in Washington State Case: An EMS crew arrives to your emergency department (ED) with a 58-year-old female who suffered a witnessed ventricular fibrillation (VF) out-of-hospital cardiac arrest (OHCA). Background: We have covered OHCA multiple times on the SGEM.

Shock 52

Shock CPR Hyperthermia / Hypothermia EMS 52

Don't Forget the Bubbles

MAY 17, 2023

Hegeman EM, et al. Schwindt EM, et al. Early Antibiotic Use and Neonatal Outcomes Among Preterm Infants Without Infections. To feed or not to feed during therapeutic hypothermia in asphyxiated neonates: a systematic review and meta-analysis. Pediatr Infect Dis J. 2023 Apr 18. Eur J Pediatr. 2023 Apr 19. Eur J Pediatr.

Pediatrics 72

Pediatrics X-Ray Interpretation Sepsis Fractures 72

RebelEM

DECEMBER 19, 2022

At REBEL EM, we’ve done an extensive write up that details some of the different types of DED and the electrophysiology behind it. Within the United States, due to paramedic shortages, this dual-medic setup does not exist in many EMS systems. That write up was for the DOSE-VF pilot trial done in March 2020 and can be found here.

EMS 52

EMS CPR Shock Resuscitation 52

EMDocs

DECEMBER 18, 2024

Upon EMS arrival the male is noted to be anxious and tremulous with a GCS of 14. Alcohol withdrawal syndrome: improving outcomes through early identification and aggressive treatment strategies. A 36-year-old male presents to the emergency department after being found down at home by his spouse. Br J Addict. 1989; 84(11): 1353-1357.

Seizures 106

Seizures Hyperthermia / Hypothermia Emergency Department EMS 106

EMDocs

DECEMBER 16, 2023

We’ll keep it short, while you keep that EM brain sharp. A 34-year-old male is brought via EMS after collapsing during an outdoor adventure race. EMS reports the patient was conscious but altered, with slurred speech and confusion. Point of care glucose in the field was 102 mg/dL. 1 Fever is usually < 40C.

Hyperthermia / Hypothermia 95

Hyperthermia / Hypothermia EMS Stroke Seizures 95

EMDocs

JUNE 1, 2023

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%

Hyperthermia / Hypothermia 86

Hyperthermia / Hypothermia Outcomes Hospitals Emergency Department 86

EMDocs

JANUARY 16, 2024

Authors: Christian Gerhart, MD (EM Resident Physician, Washington University in St. Louis); Dr. Jessica Pelletier, DO (EM Attending Physician, Washington University in St. You receive a page for a cardiac arrest and take report from emergency medical services (EMS). Per EMS he was very cold to touch.

Hyperthermia / Hypothermia 110

Hyperthermia / Hypothermia Resuscitation CPR EMS 110

ACEP Now

OCTOBER 3, 2023

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.

Fluid Resuscitation 98

Fluid Resuscitation Documentation/Coding Resuscitation EMS 98

RebelEM

JUNE 19, 2023

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?

Blood Transfusions 105

Blood Transfusions Outcomes Administration Hyperthermia / Hypothermia 105

Pediatric EM Morsels

AUGUST 9, 2024

We have previously discussed hypothermia presentations , GBS infections , and HSV infections. If not treated early, then increased risk of poor outcomes and death. The post Congenital Syphilis appeared first on Pediatric EM Morsels. Fortunately, we have addressed many neonatal issues in the PedEMMorsels. Emerg Radiol.

Hyperthermia / Hypothermia 154

Hyperthermia / Hypothermia Emergency Department Seizures Pediatrics 154

The Skeptics' Guide to EM

MARCH 2, 2019

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 emergency department with a 68-year-old man post cardiac arrest patient. Date: February 26th, 2019 Reference: Benger et al.

Airway Management 52

Airway Management CPR Hyperthermia / Hypothermia Outcomes 52

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. His heart rate is creeping up, now 140.

Resuscitation 139

Resuscitation Operations Sepsis Pediatrics 139

Taming the SRU

MAY 1, 2023

EMS was bagging him on arrival Primary notable for Compromised Airway Protection, bilateral Breath sounds, strong pulses,GCS 3 CT images of Head, Chest, Abdomen, Pelvis, and Spine No acute findings pH of 6.75 Exertional Hyperthermia Patients with heat stroke will present with Temp > 104, AMS, or seizures.

Poisoning 52

Poisoning Hyperthermia / Hypothermia Seizures Emergency Department 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 64

Hospitals Outcomes EKG/ECG Resuscitation 64

Northwestern EM Blog

JANUARY 24, 2022

And for most forms, EM physicians are not typically shocked by shock. However, even subclinical hypothyroidism with an elevated TSH but normal T4 increases risk of poor outcomes due to effects on cardiac function. They have a toolbox of strategies, mainly fluids and vasopressors, to stabilize these critically ill patients.

Anaphylaxis 52

Anaphylaxis Shock Sepsis Resuscitation 52

EB Medicine

AUGUST 1, 2018

Nachi: Sometimes… Jeff: This month’s issue was authored by Mollie Williams, who is the EM residency program director at the Brooklyn Hospital Center. Nachi: Among metabolic abnormalities, patients can present with hyperthermia, hypoglycemia, hypokalemia, hyponatremia, and metabolic acidosis.

Seizures 40

Seizures Hyperthermia / Hypothermia Administration Dehydration 40

Don't Forget the Bubbles

AUGUST 4, 2024

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. Edwards EM, et al. More studies on this topic will surely follow.

Hyperthermia / Hypothermia 52

Hyperthermia / Hypothermia Pediatrics Burns Sepsis 52

Don't Forget the Bubbles

DECEMBER 6, 2023

Abrams EM, et al. Risk Factors for Admission Hyperthermia and Associated Outcomes in Preterm Infants. Rehydration Rates and Outcomes in Overweight Children With Diabetic Ketoacidosis. Preventing Excessive Noise Exposure in Infants, Children, and Adolescents. Balk SJ, et al. Pediatrics. 2023 Nov 1;152(5):e2023063753.

Pediatrics 52

Pediatrics Hyperthermia / Hypothermia Research Hospitals 52

EMDocs

JUNE 27, 2024

Sundd P, Gladwin MT, Novelli EM. 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 98

Pediatrics Dehydration EMS Hospitals 98

Taming the SRU

JUNE 6, 2023

then need further evaluation Usually with CTA imaging If normal physical exam & ABI>0.9,

Documentation/Coding 64

Documentation/Coding Seizures Psychiatric Wellness 64