The Skeptics' Guide to EM

FEBRUARY 3, 2023

You are tidying your things […] The post SGEM#391: Is it Time for a Cool Change (Hypothermia After In-Hospital Cardiac Arrest)? Are we supposed to be starting hypothermia?” The hypothermia group was cooled using an external device to a target temperature between 32 and 34 degrees Celsius and maintained there for 24 hours.

Hyperthermia / Hypothermia 52

Hyperthermia / Hypothermia Hospitals Outcomes Documentation/Coding 52

Board Bombs

DECEMBER 5, 2021

We don’t know, and we are starting to get upset.Let’s review some hypothermia pearls, from ACEP’s PEERCert Q bank! We don’t know, and we are starting to get upset.Let’s review some hypothermia pearls, from ACEP’s PEERCert Q bank! Want to experience the greatest in board studying?

Hyperthermia / Hypothermia 52

Hyperthermia / Hypothermia 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. Therapeutic hypothermia after out-of-hospital cardiac arrest in children.

Hyperthermia / Hypothermia 52

Hyperthermia / Hypothermia Pediatrics CPR Hospitals 52

Emergency Medicine Cases

DECEMBER 8, 2020

In this month's EM Quick Hits podcast: Anand Swaminathan on lateral canthotomy, Emily Austin on pediatric cannabis poisoning, Reuben Strayer on an approach to hyperthermia, Brit Long on diagnosis and management of malignant otitis externa, Jesse McLaren on ECG diagnosis of occlusion MI in patients with BBB and Peter Brindley on prone CPR.

Hyperthermia / Hypothermia 52

Hyperthermia / Hypothermia CPR Poisoning EMS 52

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

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. Date: November 6th, 2019 Reference: Lascarrou et al.

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Hyperthermia / Hypothermia Research EMS Documentation/Coding 40

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.

Hyperthermia / Hypothermia 52

Hyperthermia / Hypothermia Fractures EMS Pediatrics 52

EMDocs

JANUARY 16, 2024

Some authors recommend not starting chest compressions in hypothermia unless there is no organized cardiac activity (e.g., 2 In reality you may start compressions before you confirm that hypothermia was the primary cause of cardiac arrest. Obtaining a core temperature early in any arrest suspected to be from hypothermia is key.

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Hyperthermia / Hypothermia Resuscitation CPR EMS 81

JournalFeed

APRIL 24, 2021

We cover leadership through change, IN midazolam for pediatric seizure, hypothermia and young infant sepsis risk, VICTAS RCT, and clinically diagnosing GHB intoxication. It’s the JournalFeed Podcast for the week of Apr 19-23, 2021.

Hyperthermia / Hypothermia 52

Hyperthermia / Hypothermia Seizures Sepsis Leadership 52

Resus Review

APRIL 6, 2015

Malignant hyperthermia is a life-threatening reaction to volatile anesthetics and the neuromuscular blocking agent succinylcholine. Dantrolene acts at the ryanodine receptor blocking the release of calcium from the sarcoplasmic reticulum, and reducing the intracellular calcium, thereby countering the effects of the malignant hyperthermia.

Hyperthermia / Hypothermia 52

Hyperthermia / Hypothermia Poisoning Administration 52

Board Bombs

NOVEMBER 5, 2019

We discuss hypothermia, diagnosis, approach to rewarming, EKG and lab findings, and complications. We discuss hypothermia, diagnosis, approach to rewarming, EKG and lab findings, and complications. Check out our interactive question bank podcast- the FIRST of its kind here: emrapidfire.supercast.tech Winter storm got you shivering?

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Hyperthermia / Hypothermia EKG/ECG 40

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

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.

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Hyperthermia / Hypothermia Poisoning Seizures COPD 86

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

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".

Hyperthermia / Hypothermia 52

Hyperthermia / Hypothermia Pediatrics EMS CPR 52

EM SIM Cases

NOVEMBER 20, 2023

Co-morbid illnesses and medications can be risk factors and can also mask the usual responses to hyperthermia such as tachycardia. Classic Hyperthermia Download From Life in the Fast Lane, ECG Library [link]. The case will progress to the diagnosis and treatment of heatstroke/ heat related illness.

Stroke 52

Stroke Hyperthermia / Hypothermia EMS EKG/ECG 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

Taming the SRU

DECEMBER 8, 2023

It is possible she was just severely hypothermic.

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Hyperthermia / Hypothermia Resuscitation Head Injuries Documentation/Coding 78

Dr. Smith's ECG Blog

JANUARY 21, 2023

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). Hypothermia can also produce bradycardia and J waves, with a pseudo-STEMI pattern. TSH came back as 45.

Hyperthermia / Hypothermia 52

Hyperthermia / Hypothermia EKG/ECG Seizures Fractures 52

ALiEM

MARCH 5, 2024

With severe toxicity, patients can have altered mental status, seizures, hyperthermia, and pulmonary edema. Salicylate has a direct effect on the respiratory center of the medulla causing tachypnea. Tinnitus, nausea, vomiting, and abdominal pain are common.

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Hyperthermia / Hypothermia Anaphylaxis Administration Poisoning 113

Dr. Smith's ECG Blog

OCTOBER 8, 2023

Severe hypothermia not uncommonly has accompanying T waves inversions. Another frequent feature of hypothermia is atrial fibrillation (not seen in this case) Core temperature of this patient was 29,5 Celsius. Maybe the main cause of the ECG-findings here then is benign T inversion and not hypothermia. There is SR.

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Hyperthermia / Hypothermia EKG/ECG Wellness Shock 99

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 83

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]

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Hyperthermia / Hypothermia Fluid Resuscitation Psychiatric Administration 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

EMDocs

DECEMBER 16, 2023

Broad-spectrum antibiotics (A) for septic shock are not inappropriate given the hyperthermia, tachycardia, and hypotension. Hyperthermia. As you attempt to examine the patient, he has a generalized, tonic-clonic seizure. What is your diagnosis, and what are your next steps in evaluation and management? 1 Fever is usually < 40C.

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Hyperthermia / Hypothermia EMS Stroke Seizures 65

Pediatric Education

MAY 7, 2023

Malignant hyperthermia is associated with inhaled anesthetics and some muscle relaxants and occurs usually very suddenly within minutes to hours. Resolution is also longer (9 or so days). Anticholinergic toxicity occurs with taking an anticholinergic agent usually within 1-2 hours with resolution within hours to days.

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Hyperthermia / Hypothermia Infectious Diseases Pediatrics Poisoning 40

PulmCCM

JUNE 12, 2023

Induced hypothermia after cardiac arrest is also called “active temperature control” or “targeted temperature management.”

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Hyperthermia / Hypothermia Academics Documentation/Coding Outcomes 105

EMDocs

NOVEMBER 6, 2023

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 90

Poisoning Hyperthermia / Hypothermia Seizures Administration 90

The Skeptics' Guide to EM

JANUARY 13, 2024

For a full list of check out the links below to the SGEM blogs: * SGEM#50: Under Pressure Journal Club: Vasopressin, Steroids and Epinephrine in Cardiac Arrest * SGEM#54: Baby It’s Cold Outside: Pre-hospital Therapeutic Hypothermia in Out of Hospital Cardiac Arrest * SGEM#59: Can I Get a Witness: Family Members Present During CPR * SGEM#64: Classic (..)

Hospitals 99

Hospitals CPR Resuscitation Airway Management 99

JournalFeed

JULY 17, 2021

We cover high risk pediatric bruising, urine concentration and UA accuracy, atrial fibrillation management, shorter NPO time for formula fed infants, and TTM2, which showed normothermia was as good as hypothermia post-arrest.

Pediatrics 52

Pediatrics Hyperthermia / Hypothermia 52

The Skeptics' Guide to EM

OCTOBER 22, 2022

SGEM#275: 10th Avenue Freeze Out – Therapeutic Hypothermia after Non-Shockable Cardiac Arrest * SGEM#306: Fire Brigade and the Staying Alive APP for OHCAs in Paris * SGEM#314: OHCA – Should you Take ‘em on the Run Baby if you Don’t get ROSC?

CPR 52

CPR Hyperthermia / Hypothermia Resuscitation EMS 52

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

Pediatric EM Morsels

SEPTEMBER 22, 2023

Shunting of blood to the extremities results in thermal dysregulation and subsequent hypothermia. Poor venous tone and inability to vasoconstrict in the extremities leads to distribution of blood volume away from the core, causing hypotension and distributive shock. Unopposed vagal tone leads to bradycardia.

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Shock Pediatrics Hyperthermia / Hypothermia Dislocations 265

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 Neonatal mastitis More common in females Most commonly staph Usually isolated SSTI without associated SBI. No further workup for SBI is indicated.

Ultrasounds 83

Ultrasounds Pediatrics Hyperthermia / Hypothermia Burns 83

Emergency Medicine Cases

APRIL 20, 2021

How is the treatment of bradycardia different in the patient with hypothermia? What are the latest recommendations about dosing of atropine and when is atropine likely to be detrimental? Cardiac ischemia? Myxedema coma? AV nodal blocker overdose? What are the most common pitfalls in utilizing transcutaneous and transvenous pacing?

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Hyperthermia / Hypothermia EMS 52

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.

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Hyperthermia / Hypothermia EMS 40