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ToxCard: Second Generation Antipsychotic Overdose

EMDocs

1,2 Neuroleptic malignant syndrome (NMS) (hyperthermia, autonomic instability, rigidity, altered mental status [AMS]) can occur as well and is most often seen with clozapine but has been observed with other atypicals. Rigidity and hyperthermia should raise concerns for NMS. 1 Seizures may occur due to lowered seizure threshold.

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What is this ECG finding? Do you understand it before you hear the clinical context?

Dr. Smith's ECG Blog

These are Osborn waves usually associated with hypothermia. He did well and was discharged. See our other blog posts of hypothermia and Osborn waves -- Massive Osborn Waves of Severe Hypothermia (23.6 Rituparna et al — as well as Chauhan and Brahma ( Int. There is also large T wave inversion and long QT.

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CritCases 12 Accidental Hypothermia and Cardiac Arrest

Emergency Medicine Cases

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.

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Neurogenic Shock in Children

Pediatric EM Morsels

” Children compensate for blood and volume loss very well… until they don’t. Shunting of blood to the extremities results in thermal dysregulation and subsequent hypothermia. As our fearless leader likes to say: “children are not aliens, but they are a special population with unique anatomy and physiology.”

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The Latest in Critical Care, 1/22/24 (Issue #26)

PulmCCM

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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2023 AHA Update on Management Cardiac Arrest or Life-Threatening Toxicity Due to Poisoning

EMDocs

Patients with severe agitation from sympathomimetic poisoning require sedation to manage hyperthermia and acidosis, to prevent rhabdomyolysis and injury, and to allow evaluation for other life-threatening conditions. Life-Threatening Cocaine Toxicity We recommend rapid external cooling for life-threatening hyperthermia from cocaine poisoning.

Poisoning 116
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Heat related illness

EM SIM Cases

This case comes from Dr. Jared Baylis and Dr. Kelly Huang Dr. Baylis is the Simulation Medical Director at University of British Columbia – Southern Medical Program and Interior Health, as well as an editor of EM Sim Cases.