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

Taming the SRU

DECEMBER 8, 2023

EMS had reported she had coded en route. ED providers should be familiar with several extraction techniques for foreign bodies in the external auditory canal including the use of manual extractors, irrigation, and other methods such as adhesives and acetone. She regained pulses with warming on arrival.

Hyperthermia / Hypothermia 78

Hyperthermia / Hypothermia Resuscitation Head Injuries Documentation/Coding 78

EM SIM Cases

NOVEMBER 20, 2023

Dr Brad Stebner is a staff Emergency physician in Kelowna, BC, Clinical Instructor at UBC and one of our editors at EM Sim Cases. Co-morbid illnesses and medications can be risk factors and can also mask the usual responses to hyperthermia such as tachycardia.

Stroke 52

Stroke Hyperthermia / Hypothermia EMS EKG/ECG 52

Emergency Medicine Cases

DECEMBER 6, 2016

In anticipation of EM Cases Episode 90 on the Pediatric Advanced Life Support (PALS) guidelines with the lead author Dr. Allan DeCaen and Dr. Anthony Crocco, Dr. 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".

Hyperthermia / Hypothermia 52

Hyperthermia / Hypothermia Pediatrics EMS CPR 52

EMDocs

FEBRUARY 15, 2024

3-6 Clinical Presentation: Symptoms include altered mental status, tachycardia, hyperthermia, urinary retention, mydriasis, blurred vision, dry skin, hallucinations. Anticholinergic toxicity has overlap with other toxicological causes of hyperthermia which are reviewed here: Hyperthermia in the Toxicological Setting.

Hyperthermia / Hypothermia 88

Hyperthermia / Hypothermia Poisoning Seizures COPD 88

The Skeptics' Guide to EM

JANUARY 13, 2024

Date: January 11, 2024 Guest Skeptic: Dr. Chris Root is an EMS fellow in the Department of Emergency Medicine at the University of New Mexico Health […] The post SGEM#426: All the Small Things – Small Bag Ventilation Masks in Out of Hospital Cardiac Arrest first appeared on The Skeptics Guide to Emergency Medicine. Resuscitation 2023.

Hospitals 104

Hospitals CPR Resuscitation Airway Management 104

Dr. Smith's ECG Blog

JANUARY 21, 2023

Case submitted and written by Dr. Mazen El-Baba and Dr. Evelyn Dell, with edits from Jesse McLaren EMS brought a John Doe, in his 30s, who was found in an urban forest near a homeless encampment on a cool fall day. EMS reported an initial GCS of 8 with pupils equal and reactive. There were no signs of trauma on scene or on the patient.

Hyperthermia / Hypothermia 52

Hyperthermia / Hypothermia EKG/ECG Seizures Fractures 52

Pediatric EM Morsels

SEPTEMBER 22, 2023

To celebrate the end of trauma season ( is it ever really over? ), we here at the Ped EM Morsels Bakery have cooked up a morsel to remind you that pediatric trauma can be even more difficult than you think. Shunting of blood to the extremities results in thermal dysregulation and subsequent hypothermia. Never fear.

Shock 273

Shock Pediatrics Hyperthermia / Hypothermia Dislocations 273

Taming the SRU

MARCH 30, 2024

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

Hyperthermia / Hypothermia 83

Hyperthermia / Hypothermia Leadership Emergency Department Seizures 83

The Skeptics' Guide to EM

OCTOBER 22, 2022

Case: You are the Chief of your local Fire and EMS Department, and an individual contacts you saying […] The post SGEM#380: OHCAs Happen and You’re Head Over Heels – Head Elevated During CPR? Head and thorax elevation during cardiopulmonary resuscitation using circulatory adjuncts is associated with improved survival.

CPR 52

CPR Hyperthermia / Hypothermia Resuscitation EMS 52

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 67

Hyperthermia / Hypothermia EMS Stroke Seizures 67

EMergucate

MAY 30, 2016

for hyperthermia) Risk of aspiration … Continue reading → Indications Loss of airway protection Loss of reflexes, e.g. obtunded /↓GCS (<8), muscle relaxed (e.g.

Hyperthermia / Hypothermia 40

Hyperthermia / Hypothermia EMS 40

Emergency Medicine Cases

JANUARY 18, 2022

The post EM Quick Hits 35 – 10 Best Papers of 2021, Peripartum Cardiomyopathy, Crashing Asthmatic, Febrile Neutropenia, Anaphylaxis update appeared first on Emergency Medicine Cases.

Anaphylaxis 52

Anaphylaxis EMS Outcomes Hyperthermia / Hypothermia 52

Emergency Medicine Cases

APRIL 20, 2021

In Part 1 of our 2-part series on bradycardia and bradydysrhythmias we discussed a practical approach with electrophysiologist Paul Dorian and EM doc Tarlan Hedayati. How is the treatment of bradycardia different in the patient with hypothermia? In this, part 2, we discuss details of treatment. Cardiac ischemia? Myxedema coma?

Hyperthermia / Hypothermia 52

Hyperthermia / Hypothermia EMS 52

Emergency Medicine Cases

MARCH 1, 2022

The post EM Quick Hits 36 – Surviving Sepsis, Angle Closure Glaucoma, Bougies, Frostbite, Hot/Altered Patient, Central Cord Syndrome appeared first on Emergency Medicine Cases.

Sepsis 52

Sepsis EMS Fluid Resuscitation Hyperthermia / Hypothermia 52

EMergucate

MAY 17, 2016

Environmental Diving Problems Drowning Electrical Injury Heat-Related Illness Hypothermia High Altitude Illness Marine Envenomations Marine Poisoning Snakebite Spider Bites Toxicology … Continue reading →

Hyperthermia / Hypothermia 40

Hyperthermia / Hypothermia EMS Poisoning 40

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 Research 40

ACEP Now

OCTOBER 3, 2023

This guideline revision is particularly timely as EMS systems have shown their abilities to dramatically improve survival and neurologic outcome after cardiac arrest, STEMI, acute stroke, and other time-sensitive conditions. 2019;154(7):e191152.

Documentation/Coding 98

Documentation/Coding Fluid Resuscitation Resuscitation Pediatrics 98

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

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

Broome Docs

OCTOBER 31, 2022

PMID: 34904190 Not surprisingly, this paper has been covered by basically everyone who talks about research, so if you want to hear some other opinions, check out the SGEM , REBEL EM , or St. Bottom line: Although this RCT demonstrates a 7 day mortality benefit of using ketamine over etomidate, the level of certainty in the results is low.

Hyperthermia / Hypothermia 52

Hyperthermia / Hypothermia Fluid Resuscitation Seizures Emergency Department 52

RebelEM

JUNE 19, 2023

This balance is upset in trauma by loss of blood and factors, acidosis, hypothermia and the inflammatory cascade. Read More Core EM: CRASH-2: Tranexamic Acid in Major Trauma References: CRASH-2 Trial Collaborators. appeared first on REBEL EM - Emergency Medicine Blog. PMID: 20554319 Post Peer Reviewed By: Salim R.

Outcomes 99

Outcomes Blood Transfusions Administration Hyperthermia / Hypothermia 99

Kings County Downstate EM

FEBRUARY 27, 2024

Author: Esteban Davila Peer Editor: Alec Feuerbach The Case You’re having a relatively quiet morning when you hear EMS bringing in a patient. EMS reports […] The post Its Getting Hot in Here: Exertional Heat Stroke Part 1 appeared first on County EM. You reflect that this day is particularly warm and humid.

Stroke 40

Stroke EMS Hyperthermia / Hypothermia 40

EMergucate

NOVEMBER 14, 2017

A 30 year old man present with altered mental state, severe life threatening hyperkalaemia, severe hyperthermia, hypotension and tachycardia. He … Continue reading →

Hyperthermia / Hypothermia 40

Hyperthermia / Hypothermia Sepsis EMS 40

EMergucate

FEBRUARY 15, 2017

A young man is brought in by ambulance with severe hyperthermia, tachycardia and tachypnoea. This has a mortality rate of … Continue reading →

Hyperthermia / Hypothermia 40

Hyperthermia / Hypothermia EMS 40

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. SGEM#64 : Classic EM Papers (OPALS Study) * SGEM#136 : CPR – Man or Machine?

CPR 52

CPR Hyperthermia / Hypothermia Resuscitation EMS 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

EM Curious

MAY 6, 2015

The idea of the FOAMed review is to give you a digestible selection of reliable content from the online EM/CC world that you can fit into your busy weekly schedule. Over a year's span we will be sure to include topics from all core EM content areas.even the ones that may not be the coolest. Read on here @ Rebel EM. Watch here.

Dislocations 52

Dislocations Hyperthermia / Hypothermia Airway Management Ultrasounds 52

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 60

Hyperthermia / Hypothermia Outcomes Hospitals Emergency Department 60

Emergency Medicine Cases

FEBRUARY 9, 2021

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? 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

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 Emergency Department Seizures 52

Dr. Smith's ECG Blog

JANUARY 30, 2019

She was ventilated by bag-valve-mask by EMS on arrival and was quickly intubated with etomidate and succinylcholine. Alexandra Schick ( with edits by Dr. Smith ) of an elderly woman who was seen in the ED for altered mental status, hyperthermia, and the initial ECG shown above. A rectal temperature was obtained which read 107.9

Hyperthermia / Hypothermia 52

Hyperthermia / Hypothermia EKG/ECG Wellness Documentation/Coding 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 →

Hyperthermia / Hypothermia 40

Hyperthermia / Hypothermia Shock Resuscitation 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 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 Shock Resuscitation EMS 40

The Skeptics' Guide to EM

MARCH 2, 2019

Case: EMS arrive to your emergency department with a 68-year-old man post cardiac arrest patient. There is no evidence for a patient-oriented benefit with epinephrine ( SGEM#238 ), other ACLS drugs ( SGEM#64 ), pre-hospital therapeutic hypothermia ( SGEM#54 , SGEM#183 ), or mechanical CPR ( SGEM#136 ).

Airway Management 52

Airway Management CPR Outcomes Hyperthermia / Hypothermia 52

EMergucate

MARCH 15, 2016

44 year old critically unwell man with low GCS and severe hypothermia Severe high anion gap metabolic acidosis with additional … Continue reading →

Hyperthermia / Hypothermia 40

Hyperthermia / Hypothermia Shock EMS 40