The Skeptics' Guide to EM

JANUARY 13, 2024

Association of small adult ventilation bags with return of spontaneous circulation in out of hospital cardiac arrest. Association of small adult ventilation bags with return of spontaneous circulation in out of hospital cardiac arrest. Case: You are dispatched to an out-of-hospital cardiac arrest (OHCA). Resuscitation 2023.

Hospitals 105

Hospitals CPR Resuscitation Airway Management 105

The Skeptics' Guide to EM

FEBRUARY 3, 2023

Temperature Control After In-Hospital Cardiac Arrest: A Randomized Clinical Trial. September 2022 Guest Skeptic: Dr. Justin Morgenstern is an emergency physician and the creator of the #FOAMed project called www.First10EM.com Case: You are working an overnight shift at a small rural hospital. Are we supposed to be starting hypothermia?”

Hyperthermia / Hypothermia 52

Hyperthermia / Hypothermia Hospitals Documentation/Coding Outcomes 52

EMDocs

JANUARY 16, 2024

He subsequently walks out of the hospital with a normal neurologic exam two weeks after admission. Some authors recommend not starting chest compressions in hypothermia unless there is no organized cardiac activity (e.g., Obtaining a core temperature early in any arrest suspected to be from hypothermia is key.

Hyperthermia / Hypothermia 104

Hyperthermia / Hypothermia Resuscitation CPR EMS 104

Greater Sydney Area HEMS

APRIL 15, 2023

It is a rare but confronting situation where a pre-hospital and retrieval medicine team are presented with a sick newborn. As a pre-hospital and retrieval service, it’s rare for us to even be around in the first few minutes of a baby’s life, but as our colleagues described, not impossible. Place a sats probe on the right hand.

Hospitals 85

Hospitals Resuscitation Hyperthermia / Hypothermia Teamwork 85

The Skeptics' Guide to EM

MAY 20, 2023

Kat Priddis is a paediatric emergency medicine consultant and trauma director at Watford General Hospital. Guest Skeptic: Dr. Kat Priddis is a paediatric emergency medicine consultant and trauma director at Watford General Hospital. Which hospital should you transfer the patient to? NEJM Evidence. N Engl J Med. NEJM Evidence.

Hyperthermia / Hypothermia 52

Hyperthermia / Hypothermia Pediatrics CPR Hospitals 52

The Skeptics' Guide to EM

NOVEMBER 16, 2019

Case: A 59-year-old […] The post SGEM#275: 10th Avenue Freeze Out – Therapeutic Hypothermia after Non-Shockable Cardiac Arrest first appeared on The Skeptics Guide to Emergency Medicine. Background: We have covered therapeutic hypothermia many times on the SGEM. This has been or out-of-hospital cardiac arrests (OHCA).

Hyperthermia / Hypothermia 40

Hyperthermia / Hypothermia EMS Research Documentation/Coding 40

Taming the SRU

DECEMBER 8, 2023

Most cases are sporadic, 20% occur among travelers Outbreaks can occur within buildings, workplaces, hospitals Accounts for 1-10% of CAP, co-infection uncommon Consider sending Legionella testing, or treating empirically Treatment requires at least 5 days of fluoroquinolone or macrolide (levofloxacin or azithromycin recommended)

Hyperthermia / Hypothermia 88

Hyperthermia / Hypothermia Head Injuries Resuscitation Documentation/Coding 88

EMDocs

JUNE 12, 2024

Previous triad of death = hypothermia, acidosis, and coagulopathy. Liver dysfunction, secondary cirrhosis, critical illness, trauma, and hypothermia reduce citrate metabolism. Hypothermia also leads to hypoCa. Today on the emDOCs cast with Brit Long, MD ( @long_brit) , we look at hypocalcemia in trauma and the diamond of death.

Hyperthermia / Hypothermia 104

Hyperthermia / Hypothermia Resuscitation Administration Blood Transfusions 104

The Skeptics' Guide to EM

DECEMBER 16, 2017

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. Case: Johnny is a […] The post SGEM#199: Therapeutic Hypothermia – What is it Good For? He is known to have poorly controlled epilepsy.

Hyperthermia / Hypothermia 40

Hyperthermia / Hypothermia Seizures Hospitals Stroke 40

Taming the SRU

MARCH 30, 2024

Predictions scores such as the HOPE score can be used to guide treatment.

Hyperthermia / Hypothermia 95

Hyperthermia / Hypothermia Leadership Emergency Department Seizures 95

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

PulmCCM

JUNE 12, 2023

Induced hypothermia after cardiac arrest is also called “active temperature control” or “targeted temperature management.” Temperature management (or fever avoidance) should begin immediately after cardiac arrest (ideally in the emergency department, for out-of-hospital arrests) and continued for at least 72 hours.

Hyperthermia / Hypothermia 105

Hyperthermia / Hypothermia Academics Documentation/Coding Outcomes 105

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. JAMA Cardiol. 1.15; P= 0.32

Hospitals 59

Hospitals Outcomes EKG/ECG Resuscitation 59

EM SIM Cases

NOVEMBER 3, 2023

CLINICAL VIGNETTE 58 y/o M presents with hyperthermia and confusion, and was found by bystanders to be acting strange. CASE SUMMARY In this case of exertional heatstroke, the team must identify hyperthermia and actively cool the patient while working the patient up for other causes. Link can be found here.

Hyperthermia / Hypothermia 52

Hyperthermia / Hypothermia EKG/ECG EMS Hospitals 52

The Skeptics' Guide to EM

JULY 3, 2021

Hypothermia versus Normothermia after Out-of-Hospital Cardiac Arrest. Hypothermia versus Normothermia after Out-of-Hospital Cardiac Arrest. Background: Hypothermia has been a mainstay of post-arrest care after the publication of two trials in 2002 that both suggested a benefit. This gives a NNT of 4.

Hyperthermia / Hypothermia 52

Hyperthermia / Hypothermia Hospitals Outcomes Wellness 52

PulmCCM

JANUARY 29, 2024

automated external cooling system) for all arrest patients (with any presenting rhythm, occurring in- or out-of-hospital) maintained for at least 24 hours; longer periods of fever prevention (which AHA now calls “temperature control”) for persistently comatose patients are also considered reasonable. °C/hour).

Seizures 115

Seizures CPR Documentation/Coding Hyperthermia / Hypothermia 115

Northwestern EM Blog

MAY 9, 2022

For this reason, carbidopa/levodopa should never be discontinued during hospital admission - or ED boarding. [1] The most acute cause of death from NMS is hyperthermia, which is induced both by D2 receptor antagonism leading to rigidity and impaired thermoregulation from the striatum and hypothalamus. References 1. 12 March 2015.

Hyperthermia / Hypothermia 52

Hyperthermia / Hypothermia Fluid Resuscitation Psychiatric Emergency Department 52

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

Don't Forget the Bubbles

FEBRUARY 5, 2025

All hospitals will have different makeups of trauma teams and possibly different levels of activation) Do I need any additional expertise outside of who would typically be in the trauma team? In the bleeding trauma patient, fluid resuscitation aims to avoid the diamond of death (acidosis, coagulopathy, hypothermia and hypocalcaemia).

Domestic Violence 59

Domestic Violence Fluid Resuscitation Head Injuries Sexual Assault 59

ACEP Now

APRIL 3, 2024

Early work on TTM in 2002 showed benefit to cooling to 33 degrees Celsius, which subsequently influenced international resuscitation guidelines to recommend mild hypothermia at 32 degrees to 34 degrees Celsius in 2005. degrees Celsius. 5,6 In 2021, the TTM2 trial was published. degrees Celsius for 72 hours. Click to enlarge.

Hyperthermia / Hypothermia 40

Hyperthermia / Hypothermia Resuscitation Outcomes Hospitals 40

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. First aid done pre-hospital. Assess pupillary reaction to light. Remove clothing which may be contaminated with chemicals and jewellery which may cause constriction if swelling occurs.

Burns 52

Burns Fluid Resuscitation PPE Resuscitation 52

Don't Forget the Bubbles

JUNE 19, 2023

The centile used to define “small” may differ both by scientific study and by hospital. Hypothermia should be prevented both directly after birth (this includes considering the use of polythene bags in very small neonates born >32 weeks) and during admission. We commonly use less than the tenth centile.

Pediatrics 143

Pediatrics Ultrasounds Hyperthermia / Hypothermia Sepsis 143

The Skeptics' Guide to EM

OCTOBER 22, 2022

Background: We have covered Out of Hospital Cardiac Arrests (OHCAs) many, many times on the SGEM. Case: You are the Chief of your local Fire and EMS Department, and an individual contacts you saying he saw a piece on TV about a “Heads Up” CPR device, and he wants to donate half the cost and has his checkbook out.

CPR 52

CPR Hyperthermia / Hypothermia Resuscitation EMS 52

RebelEM

JUNE 19, 2023

This balance is upset in trauma by loss of blood and factors, acidosis, hypothermia and the inflammatory cascade. Primary Results Patients enrolled from 15 emergency medical services at 21 hospitals across 3 countries over 7 years. absolute decrease in death in trauma patients with significant bleeding randomized TXA (NNT = 66).

Blood Transfusions 105

Blood Transfusions Outcomes Administration Hyperthermia / Hypothermia 105

Northwestern EM Blog

JUNE 16, 2024

Myocardial Infarction Medication Sinus node dysfunction Infectious Disease Hypothermia Metabolic Abnormalities (hypothyroidism, hyperkalemia, ect.) Hypothermia Moderate to severe hypothermia can cause significant bradycardia leading to hypotension. Hypothermia. Treatment includes permanent pacemaker placement [9].

Hyperthermia / Hypothermia 52

Hyperthermia / Hypothermia Infectious Diseases Stroke Poisoning 52

The Skeptics' Guide to EM

FEBRUARY 11, 2023

NEJM 2022 Guest Skeptic: Dr. Sean Moore is an emergency physician working in Kenora Ontario, where he is Chief of Staff at Lake of the Woods District Hospital, Northern Medical Director for the Ornge air medical transport program and associate medical director with CritiCall Ontario. An anesthetist is working with him for the procedures.

Shock 56

Shock CPR Hyperthermia / Hypothermia Hospitals 56

Emergency Medicine Cases

FEBRUARY 9, 2021

How do we mitigate the risk of hypothermia? What can hospitals do to mitigate blood wastage? What should be the lab resuscitation targets? Why is serum calcium important to draw in the ED for the patient who is exsanguinating?

Hyperthermia / Hypothermia 52

Hyperthermia / Hypothermia Resuscitation Hospitals EMS 52

The Skeptics' Guide to EM

MAY 8, 2021

CPR is initiated and a hospital rapid response team is called. Background: Cardiac arrests have high morbidity and mortality rates both in-hospital cardiac arrests (IHCAs) and out of hospital cardiac arrests (OHCAs). The resuscitation team arrives and ACLS protocols are continued. I have not seen a validation study published.

CPR 52

CPR Hyperthermia / Hypothermia EMS Documentation/Coding 52

ACEP Now

OCTOBER 11, 2024

3 Hypothermia is commonly encountered in submersion episodes, regardless of geographic location and season, although case reports have hypothesized improved neurologic outcomes, possibly due to the protective effects of the lower body temperatures. pediatric hospitals. Additionally, there is not a role for prophylactic antibiotics.

Pediatrics 52

Pediatrics Hyperthermia / Hypothermia Emergency Department Resuscitation 52

ACEP Now

OCTOBER 3, 2023

There are at least 600 TBI-related hospitalizations and 175 TBI-related deaths per day. 2,3 TBI outcomes are profoundly linked to the timing and quality of care provided before patients reach the hospital.

Fluid Resuscitation 98

Fluid Resuscitation Documentation/Coding Resuscitation EMS 98

The Skeptics' Guide to EM

SEPTEMBER 29, 2018

Intraosseous Vascular Access Is Associated With Lower Survival and Neurologic Recovery Among Patients With Out-of-Hospital Cardiac Arrest. Intraosseous Vascular Access Is Associated With Lower Survival and Neurologic Recovery Among Patients With Out-of-Hospital Cardiac Arrest. BLS for out-of-hospital cardiac arrest (OHCA).

Basic Life Support 52

Basic Life Support Airway Management CPR Resuscitation 52

EM Literature of Note

JANUARY 9, 2022

A Chilling Conclusion to the Hypothermia Debate? link] Effect of Moderate vs Mild Therapeutic Hypothermia on Mortality and Neurologic Outcomes in Comatose Survivors of Out-of-Hospital Cardiac Arrest 31°C was no better than 34°C for improving neurologic outcomes following OHCA. the subsequent hospitalization rate was around 10%.

Hyperthermia / Hypothermia 40

Hyperthermia / Hypothermia Stroke Emergency Department Outcomes 40

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. They had a difficult time getting a definitive airway pre-hospital. Tracheal Intubation During Out-of-Hospital Cardiac Arrest on Functional Outcome.

Airway Management 52

Airway Management CPR Hyperthermia / Hypothermia Outcomes 52

The Skeptics' Guide to EM

JANUARY 9, 2021

Association of Intra-arrest Transport vs Continued On-Scene Resuscitation With Survival to Hospital Discharge Among Patients With Out-of-Hospital Cardiac Arrest. Association of Intra-arrest Transport vs Continued On-Scene Resuscitation With Survival to Hospital Discharge Among Patients With Out-of-Hospital Cardiac Arrest.

EMS 52

EMS Resuscitation CPR Hyperthermia / Hypothermia 52

The Skeptics' Guide to EM

AUGUST 14, 2021

Survival After Intravenous Versus Intraosseous Amiodarone, Lidocaine, or Placebo in Out-of-Hospital Shock-Refractory Cardiac Arrest. Survival After Intravenous Versus Intraosseous Amiodarone, Lidocaine, or Placebo in Out-of-Hospital Shock-Refractory Cardiac Arrest. Date: August 12th, 2021 Reference: Daya et al. Reference: Daya et al.

Shock 52

Shock CPR Hyperthermia / Hypothermia EMS 52

The Skeptics' Guide to EM

OCTOBER 24, 2020

Mobile Smartphone Technology Is Associated With Out-of-hospital Cardiac Arrest Survival Improvement: The First Year “Greater Paris Fire Brigade” Experience. Mobile Smartphone Technology Is Associated With Out-of-hospital Cardiac Arrest Survival Improvement: The First Year “Greater Paris Fire Brigade” Experience.

CPR 52

CPR Hyperthermia / Hypothermia Resuscitation EMS 52

Don't Forget the Bubbles

MAY 17, 2023

The Bubble Wrap Plus is a monthly paediatric journal club reading list from Anke Raaijmakers, working with Professor Jaan Toelen and his team at the University Hospitals in Leuven. Disparities in Clinical Ethics Consultation Among Hospitalized Children: A Case-Control Study. Can’t get enough of Bubble Wrap? Kurepa D, et al.

Pediatrics 72

Pediatrics X-Ray Interpretation Sepsis Fractures 72