EMCrit 356 – More on Accidental Hypothermia with Ken Zafren
EMCrit
AUGUST 29, 2023
A deeper dive on accidental hypothermia in anticipation of my much awaited winter EMCrit Project by Scott Weingart, MD FCCM.
Hyperthermia / Hypothermia Related Topics 
ToxCard: Second Generation Antipsychotic Overdose
EMDocs
NOVEMBER 19, 2024
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.
Poisoning 
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Hypothermia & Non-Freezing Cold Injury
EM Ottawa
MAY 9, 2024
In this blog post, I’ll go into a more in-depth review of the staging of hypothermia and how to manage this problem in the field. Furthermore, I’ll […] The post Hypothermia & Non-Freezing Cold Injury appeared first on EMOttawa Blog.
Emergent Management of Hyperthermia
EM Updates
AUGUST 11, 2020
Emergent Management of Hyperthermia (pdf) Emergent Management of Hyperthermia (png)
What is this ECG finding? Do you understand it before you hear the clinical context?
Dr. Smith's ECG Blog
FEBRUARY 2, 2024
These are Osborn waves usually associated with hypothermia. See our other blog posts of hypothermia and Osborn waves -- Massive Osborn Waves of Severe Hypothermia (23.6 Presumably, this is the result of body shivering , that so often accompanies hypothermia once temperatures drop below 30-32°C ( = 86-90°F ).
Dantrolene for Malignant Hyperthermia
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.
CritCases 12 Accidental Hypothermia and Cardiac Arrest
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.
EM Quick Hits 24 Lateral Canthotomy, Cannabis Poisoning, Hyperthermia, Malignant Otitis Externa, BBB in Occlusion MI, Prone CPR
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.
40. Hypothermia- The Great Chicago Cold
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?
Journal Jam 19 Therapeutic Hypothermia After Cardiac Arrest – Mixed Evidence
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.
126. Hypothermia: can we please just use Celsius?
Board Bombs
DECEMBER 5, 2021
We dont know, and we are starting to get upset.Lets review some hypothermia pearls, from ACEPs PEERCert Q bank! We dont know, and we are starting to get upset.Lets review some hypothermia pearls, from ACEPs PEERCert Q bank! Want to experience the greatest in board studying?
126. Hypothermia: can we please just use Celsius?
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?
SGEM#275: 10th Avenue Freeze Out – Therapeutic Hypothermia after Non-Shockable Cardiac Arrest
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.
EM Quick Hits 30 Scaphoid Fracture, Therapeutic Hypothermia, HEADS-ED, Pelvic Trauma, Kratom, Femoral Lines
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.
SGEM#391: Is it Time for a Cool Change (Hypothermia After In-Hospital Cardiac Arrest)?
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.
Neurogenic Shock in Children
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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Leading Change | IN Midazolam Seizure | Hypothermia Infant Sepsis | VICTAS RCT | GHB Dx
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.
SGEM #404: Sitting on the Dock of the Bay-esian Interpretation of Therapeutic Hypothermia for Pediatric Cardiac Arrest
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.
CICM Second Part Exam Practice SAQs 13022025
Intensive Blog
FEBRUARY 14, 2025
Examples of common relevant toxidromes include: Sympathomimetic : e.g. agitation, tachycardia, hypertension, and hyperthermia. Anticholinergic : e.g. dry skin, mydriasis, urinary retention, and altered mental status. Serotonin toxicity: CNS (confusion, agitation), Autonomic (e.g. HR, BP changes), neuromuscular (e.g.
Infant hypothermia | Non-sterile Lac Repair
JournalFeed
SEPTEMBER 17, 2022
Infant hypothermia Spoon Feed There is significant practice pattern variation in the ED management of infants ≤90 days of age with hypothermia. These are summaries from just 2 of the 5 article we cover every week! For access to more, please visit JournalFeed.org for details about becoming a member.
40. Hypothermia- The Great Chicago Cold
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?
Grand Rounds Recap 11.15.23
Taming the SRU
DECEMBER 8, 2023
It is possible she was just severely hypothermic.
SGEM#199: Therapeutic Hypothermia – What is it Good For?
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.
The Latest in Critical Care, 1/22/24 (Issue #26)
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.
2023 AHA Update on Management Cardiac Arrest or Life-Threatening Toxicity Due to Poisoning
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.
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Heat related illness
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.
Issue #4: The Latest in Critical Care, 6/12/23
PulmCCM
JUNE 12, 2023
Induced hypothermia after cardiac arrest is also called “active temperature control” or “targeted temperature management.”
SGEM#426: All the Small Things – Small Bag Ventilation Masks in Out of Hospital Cardiac Arrest
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 109
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SGEM#336: You Can’t Always Get What You Want – TTM2 Trial
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.
Lab Case 169 – Interpretation
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 →
Lab Case 134 – Interpretation
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 →
Targeted temperature management for post-cardiac arrest is officially over (for now)
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.
Symptomatic Bradycardia: Considering the Differential Diagnosis
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].
EM Notes – Intubation
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.
Pediatric Bruising | UA Spec Grav + Accuracy | Afib Management | NPO Post Formula Feed | TTM2 RCT
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
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Grand Rounds Recap 4.5.23
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.
The Science on Targeted Temperature Management
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. Adding nuance, this study also showed that the highest-severity arrests did not benefit from hypothermia.
Chemical Burns
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. Assess pupillary reaction to light. Remove clothing which may be contaminated with chemicals and jewellery which may cause constriction if swelling occurs.
Burns 52
52 
Fetal Growth Restriction and Small for Gestational Age Babies
Don't Forget the Bubbles
JUNE 19, 2023
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. Poor nutrition during pregnancy may pre-dispose the fetus to chronic disease in later life – the so-called Barker hypothesis.
Pediatrics 143
143 
CICM Second Part Exam Practice SAQs 22082024
Intensive Blog
AUGUST 21, 2024
(FBC, coags, +/- TEG/ROTEM) Extubate when no return to OT, warm, pain controlled, and protects own airway Seek and treat complications from hypoperfusion, branch occlusion, and surgery Chest – wounds, drain outputs, PTX, HTX, atelectasis Cardiac – valve dysfunction, ischemia, conduction defects (ECG, Echo) CPB Cx (e.g.
Burns 52
52 SGEM#183: Don’t RINSE, Don’t Repeat
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).
Ep 155 Treatment of Bradycardia and Bradydysrhythmias
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?
FOAM Eye-Catchers 3
EMergucate
NOVEMBER 22, 2013
The End of Therapeutic Hypothermia? GAME CHANGER! HOT OF THE PRESS: this new article in NEJM, the Targeted Temperature Management … Continue reading →
Grand Rounds Recap 4.10.24
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 96
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