Emergency Medicine Cases

JANUARY 29, 2019

In this CritCases blog Michael Misch takes us through a case of accidental hypothermia and cardiac arrest, reviewing the controversies in management as well as the guidelines for rewarming, the role of ECMO and the alterations to ACLS cardiac arrest medications, CPR and defibrillations.

Hyperthermia / Hypothermia 52

Hyperthermia / Hypothermia CPR Wellness Resuscitation 52

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. Calcium and resuscitation Severely injured trauma patients are commonly hypocalcemic.

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Hyperthermia / Hypothermia Resuscitation Administration Blood Transfusions 89

Emergency Medicine Cases

OCTOBER 5, 2021

In this Journal Jam podcast, special guest Dr. Mizuho Morrison joins Anton and Justin to clear up the muddy waters of therapeutic hypothermia with a deep dive into the world’s literature. The post Journal Jam 19 Therapeutic Hypothermia After Cardiac Arrest – Mixed Evidence appeared first on Emergency Medicine Cases.

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Hyperthermia / Hypothermia Resuscitation EMS 52

Emergency Medicine Cases

DECEMBER 6, 2016

The post Best Case Ever 52 – Pediatric Hypothermia Cardiac Arrest appeared first on Emergency Medicine Cases. DeCaen tells his Best Case Ever showing us the value of orchestrated team work and a great example of the saying, "they're not dead until they're warm and dead".

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Hyperthermia / Hypothermia Pediatrics EMS CPR 52

The Skeptics' Guide to EM

MAY 20, 2023

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. They started cardiopulmonary resuscitation (CPR) until EMS arrived.

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Hyperthermia / Hypothermia Pediatrics CPR Hospitals 52

Emergency Medicine Cases

JULY 13, 2021

The post EM Quick Hits 30 Scaphoid Fracture, Therapeutic Hypothermia, HEADS-ED, Pelvic Trauma, Kratom, Femoral Lines appeared first on Emergency Medicine Cases.

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Hyperthermia / Hypothermia Fractures EMS Pediatrics 52

Taming the SRU

MARCH 30, 2024

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

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Hyperthermia / Hypothermia Leadership Emergency Department Seizures 93

The Skeptics' Guide to EM

DECEMBER 16, 2017

Hypothermia for Neuroprotection in Convulsive Status Epilepticus. Case: Johnny is a […] The post SGEM#199: Therapeutic Hypothermia – What is it Good For? Hypothermia for Neuroprotection in Convulsive Status Epilepticus. Background: We have covered hypothermia a number of times on the SGEM. Reference: Legriel et al.

Hyperthermia / Hypothermia 40

Hyperthermia / Hypothermia Seizures Hospitals Stroke 40

The Skeptics' Guide to EM

JANUARY 13, 2024

Resuscitation 2023. Resuscitation 2023. Your EMS agency has equipped you with small-volume adult bag-valve masks (BVMs), the first responders have been utilizing a standard adult BVM thus far during the resuscitation. Your partner asks you which of the two BVMs you should use to continue the resuscitation.

Hospitals 88

Hospitals CPR Resuscitation Airway Management 88

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.

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Hyperthermia / Hypothermia Outcomes Research Hospitals 80

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.

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Hyperthermia / Hypothermia Resuscitation Outcomes Hospitals 40

Greater Sydney Area HEMS

APRIL 15, 2023

At one of our recent education days we heard Dr Mark Russell and Dr Mark Newcombe deliver excellent presentations of cases which they had been involved in, involving resuscitative hysterotomy and neonatal resuscitation respectively. Resuscitate in air first, and use higher inflation pressures than you would with adults.

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Hospitals Resuscitation Hyperthermia / Hypothermia Teamwork 85

EMDocs

NOVEMBER 6, 2023

Use of 20% intravenous lipid emulsion can be efficacious in the resuscitation of life-threatening local anesthetic toxicity, especially from bupivacaine. Life-Threatening Cocaine Toxicity We recommend rapid external cooling for life-threatening hyperthermia from cocaine poisoning. Try calcium; consider pacing! COR 1, LOE C-LD.

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Poisoning Hyperthermia / Hypothermia Seizures Administration 94

Dr. Smith's ECG Blog

FEBRUARY 8, 2022

The patient was put on Extracorporeal Life Support in the ED 3 hours after initial resuscitation, the core temp was 30° C and the patient was defibrillated with a single attempt. Instead of ST elevation that is commonly reported with hypothermia-induced Osborn waves — ECG #1 was remarkable for diffuse and profound ST depression.

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Hyperthermia / Hypothermia CPR EKG/ECG Resuscitation 40

PulmCCM

JANUARY 29, 2024

Patients presenting with hypothermia should not be warmed too quickly (allowing their temperature to increase by <0.5°C/hour). There should be an active approach to fever prevention (e.g., °C/hour). ECMO used as CPR is referred to as ECPR.)

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Seizures CPR Documentation/Coding Hyperthermia / Hypothermia 115

The Skeptics' Guide to EM

OCTOBER 22, 2022

Head and thorax elevation during cardiopulmonary resuscitation using circulatory adjuncts is associated with improved survival. Resuscitation 2022 Guest Skeptic: Clay Odell is a Paramedic, Firefighter, and registered nurse (RN). Resuscitation 2022 Guest Skeptic: Clay Odell is a Paramedic, Firefighter, and registered nurse (RN).

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CPR Hyperthermia / Hypothermia Resuscitation EMS 52

Northwestern EM Blog

MAY 9, 2022

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. Any life-threatening hyperthermia should be treated immediately with an ice bath.[2] Therefore, fluid resuscitation and maintenance are important.

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Hyperthermia / Hypothermia Fluid Resuscitation Psychiatric Administration 52

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).

Outcomes 105

Outcomes Blood Transfusions Administration Hyperthermia / Hypothermia 105

Taming the SRU

APRIL 11, 2024

Management Antibiotics with staph coverage Most spontaneously drain and do not require I&D Hypothermia in neonates Varying definitions with consensus < 36-36.5 Correct pronunciation and understanding of personal narratives is important. There is history behind a person’s name which often has deep and personal meaning.

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Ultrasounds Pediatrics Hyperthermia / Hypothermia Burns 93

EMDocs

JUNE 25, 2024

Fluid resuscitation target and fluid Fluid resuscitation is one of the most important parts of management; goal is to increase intravascular volume and ensure end organ perfusion. Calculating fluid resuscitation: Parkland formula: 4 mL X % TBSA X weight in kilograms. IOs and central lines are also options. J Burn Care Res.

Burns 73

Burns Fluid Resuscitation Resuscitation Poisoning 73

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.).

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Resuscitation Operations Sepsis Pediatrics 139

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.

Hyperthermia / Hypothermia 52

Hyperthermia / Hypothermia EKG/ECG EMS Hospitals 52

Taming the SRU

NOVEMBER 4, 2023

Yates Foot Infection NSTIs are rare but deadly pathology that need to be considered with any soft tissue infection NSTI is a clinical diagnosis, but there are many imaging and laboratory assessments to help increase clinical suspicion Expedited disposition to the OR for NSTIs under 12 hours from ED presentation significantly decreases mortality Emesis (..)

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Hyperthermia / Hypothermia Resuscitation Burns Emergency Department 83

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

Pediatric Emergency Playbook

MARCH 1, 2016

The Trauma Death Spiral Lethal triad of hypothermia, acidosis, and coagulopathy. Resuscitative Pearls Our goal here is damage control. Otherwise, resuscitate, identify the bleeding source, and slow or stop the bleeding with blood products or surgery. Puffer fish or blob: a hyperfibrinolytic tracing.

Resuscitation 40

Resuscitation Pediatrics Hyperthermia / Hypothermia Operations 40

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).

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Hyperthermia / Hypothermia EKG/ECG Seizures Fractures 52

ACEP Now

OCTOBER 3, 2023

The GCS should be measured after airway, breathing, and circulation are assessed, after a clear airway is established, and after necessary ventilatory or circulatory resuscitation has been performed. The GCS must be obtained through interaction with the patient (i.e.,

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Fluid Resuscitation Documentation/Coding Resuscitation EMS 98

Intensive Blog

AUGUST 21, 2024

Outline the initial assessment of severe burns injury, including how you will calculate fluid resuscitation requirements. Discuss the advantages and disadvantages of using pulse oximetry to target oxygen therapy (50%) What SpO2 targets do you use in ICU patients and why? (50%) 50%) Oxygen saturation targets in critical care Q2.

Burns 52

Burns Fluid Resuscitation Hyperthermia / Hypothermia Operations 52

EMergucate

JUNE 7, 2017

A 49 year old man with confusion, hypothermia and shock requiring urgent resuscitation has blood results which showSevere HAGMA uncompensated, … Continue reading →

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Hyperthermia / Hypothermia Shock Resuscitation EMS 40

EMergucate

JUNE 11, 2017

A 49 year old man with confusion, hypothermia and shock requiring urgent resuscitation has blood results which show The same … Continue reading →

Hyperthermia / Hypothermia 40

Hyperthermia / Hypothermia Resuscitation Shock EMS 40

EMergucate

JUNE 14, 2017

A 49 year old man with confusion, hypothermia and shock requiring urgent resuscitation has blood results which show The patient … Continue reading →

Hyperthermia / Hypothermia 40

Hyperthermia / Hypothermia Resuscitation Shock EMS 40

Emergency Medicine Cases

FEBRUARY 9, 2021

What should be the lab resuscitation targets? How do we mitigate the risk of hypothermia? Once the dust settles, what do we need to tell the patient and/or their family about the consequences of being massively transfused? 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

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

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. Pediatric submersion injuries: emergency care and resuscitation. J Surg Res.

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Pediatrics Hyperthermia / Hypothermia Emergency Department Resuscitation 52

The Skeptics' Guide to EM

SEPTEMBER 29, 2018

His primary interests are resuscitation, prehospital critical […] The post SGEM#231: You’re So Vein – IO vs. IV Access for OHCA first appeared on The Skeptics Guide to Emergency Medicine. His primary interests are resuscitation, prehospital critical care, airway management, and point-of-care ultrasound.

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Basic Life Support Airway Management CPR Resuscitation 52

The Skeptics' Guide to EM

OCTOBER 24, 2020

You abandon your coffee order and quickly head next-door, where you are able to start cardiopulmonary resuscitation (CPR) and direct a bystander to find the store’s automated external defibrillator (AED) while waiting for emergency medical services (EMS) to arrive.

CPR 52

CPR Hyperthermia / Hypothermia Resuscitation EMS 52

Taming the SRU

APRIL 13, 2023

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.

Hyperthermia / Hypothermia 52

Hyperthermia / Hypothermia Poisoning EKG/ECG Seizures 52