Pediatric EM Morsels

SEPTEMBER 22, 2023

Shunting of blood to the extremities results in thermal dysregulation and subsequent hypothermia. While we may allow permissive hypotension in damage control resuscitation of hemorrhagic shock, in neurogenic shock you should maintain an age-appropriate blood pressure. Unopposed vagal tone leads to bradycardia. J Pediatr Surg.

Shock 268

Shock Pediatrics Hyperthermia / Hypothermia Dislocations 268

ACEP Now

OCTOBER 3, 2023

These guidelines present the best available evidence to support clinical decision making in the prehospital setting when TBI care may have the most significant impact on outcomes; they also establish a research agenda for future investigations. This document is an update of guidelines first published in 2000, and then updated in 2007.

Documentation/Coding 98

Documentation/Coding Fluid Resuscitation Resuscitation EMS 98

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

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

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). “Prompt” electroencephalogram (EEG) was advised strongly for all cardiac arrest survivors not following commands.

Seizures 115

Seizures CPR Documentation/Coding Hyperthermia / Hypothermia 115

The Skeptics' Guide to EM

AUGUST 14, 2021

This has included the classic paper from Legend of EM Dr. Ian Stiell on BLS vs. ACLS ( SGEM#64 ), the use of mechanical CPR ( SGEM#136 ), and pre-hospital hypothermia ( SGEM#183 ). The key result was that significantly fewer patients had a favorable neurologic outcome in the IO group compared to the IV group.

Shock 52

Shock CPR Hyperthermia / Hypothermia EMS 52

The Skeptics' Guide to EM

MAY 8, 2021

The resuscitation team arrives and ACLS protocols are continued. Improving outcomes for patients with cardiac arrests has been an ongoing challenge in pre-hospital and in hospital medicine. That RCT had 268 patients and demonstrated a better odds ratio for ROSC and survival to discharge with good neurologic outcome.

CPR 52

CPR Hyperthermia / Hypothermia EMS Documentation/Coding 52

The Skeptics' Guide to EM

MARCH 2, 2019

Tracheal Intubation During Out-of-Hospital Cardiac Arrest on Functional Outcome. Tracheal Intubation During Out-of-Hospital Cardiac Arrest on Functional Outcome. Clinical Question #1: Are superglottic airway devices non-inferior to endotracheal intubation in OHCA with regards to neurologic outcome? Chest compression fraction.

Airway Management 52

Airway Management CPR Outcomes Hyperthermia / Hypothermia 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.

Basic Life Support 52

Basic Life Support Airway Management CPR Resuscitation 52

EMDocs

DECEMBER 16, 2023

Evaporative cooling is the preferred method to actively reduce body temperature in the emergency department , as it can be performed with ongoing resuscitation efforts. 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?

Hyperthermia / Hypothermia 68

Hyperthermia / Hypothermia EMS Stroke Seizures 68

EMDocs

JUNE 27, 2024

Intravenous fluid therapy and hospital outcomes for vaso-occlusive episodes in children, adolescents, and young adults with sickle cell disease. Factors associated with adverse outcome among children with sickle cell disease admitted to the pediatric intensive care unit: an observational cohort. C or 100.4 mg/kg, max 0.4 C or 100.4

Pediatrics 75

Pediatrics Dehydration EMS Hospitals 75

EMDocs

MAY 28, 2024

Fluid management Goal is euvolemia Dehydration – needs IV fluid resuscitation. Hypothermia, hypotension, and vasoconstriction may affect pulse oximetry reading, which is based on light absorption from fingertip blood flow. Causes and outcomes of the acute chest syndrome in sickle cell disease. times maintenance.

Blood Transfusions 75

Blood Transfusions Fluid Resuscitation Dehydration Ultrasounds 75

Emergency Medicine Ireland

APRIL 4, 2022

The scheduled, usually elective nature of cardiac surgery lends itself to large scale outcome prediction and indeed, cardiac surgery has found its outcomes examined very closely over the past few decades. Likely driven by rewarming induced vasodilation and hypothermia induced diuresis they can be hypovolaemic.

Fluid Resuscitation 40

Fluid Resuscitation Hyperthermia / Hypothermia Outcomes Resuscitation 40

EMDocs

JANUARY 8, 2024

Magnesium does not improve ROSC, survival, or neurologic outcomes, no matter the presenting rhythm (Level 3: no benefit). Patients with spontaneous hypothermia after ROSC unresponsive to verbal commands should not routinely be actively or passively rewarmed faster than 0.5° COR 2b, LOE C-LD. C per hour. COR 2b, LOE C-EO. Circulation.

Seizures 82

Seizures Shock CPR Hyperthermia / Hypothermia 82

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.

Hyperthermia / Hypothermia 40

Hyperthermia / Hypothermia Resuscitation Outcomes Hospitals 40

Taming the SRU

AUGUST 25, 2023

to 1 mcg/kg/hour procedural sedation loading dose: 0.5-1 1 mcg/kg over 10 minutes followed by continuous infusion: 0.2 to 1 mcg/kg/hour procedural sedation loading dose: 0.5-1 1 mcg/kg over 10 minutes followed by continuous infusion: 0.2 to 1 mcg/kg/hour procedural sedation loading dose: 0.5-1

Seizures 68

Seizures Fractures EKG/ECG Resuscitation 68

EMDocs

JUNE 12, 2024

Previous triad of death = hypothermia, acidosis, and coagulopathy. HypoCa is common in trauma patients and is associated with poor outcomes. Liver dysfunction, secondary cirrhosis, critical illness, trauma, and hypothermia reduce citrate metabolism. Hypothermia also leads to hypoCa. Whole blood does contain less citrate.

Hyperthermia / Hypothermia 89

Hyperthermia / Hypothermia Resuscitation Administration Blood Transfusions 89

Thinking Critical Care

MAY 18, 2023

This hypovolaemic shock state was to be maintained for one or two hours before the shed blood was retransfused and the effect of experimental drugs on resuscitation could be tested. [11] I do not recall one experiment getting as far as the resuscitation stage. The Shock Team had an office with three desks, one for each of us.

Shock 40

Shock Research Sepsis Resuscitation 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

Don't Forget the Bubbles

JUNE 26, 2023

The team start CPR, and this is emergently converted to extra-corporeal cardiopulmonary resuscitation via the open sternotomy wound. The JET is treated by deepening sedation (to minimise exogenous and endogenous catecholamines), optimizing electrolytes and active mild hypothermia. What is the best option for repair?

Operations 126

Operations Research Hyperthermia / Hypothermia Hospitals 126

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

RebelEM

MARCH 30, 2023

Background: Previous observational studies published in 2015 (Geri 2015)(Vyas 2015) indicated that early cardiac catheterization in patients with out-of-hospital cardiac arrest (OHCA) might improve mortality and result in more favorable neurological outcomes. Article: How-Berlemont C, Lamhaut L, Diehl J, et al. 1.15; P= 0.32 1.15; P= 0.31

Hospitals 56

Hospitals Outcomes EKG/ECG Resuscitation 56

EM Literature of Note

JANUARY 9, 2022

The Annals of Emergency Medicine Podcast continues apace, with free monthly updates from the original research published in the journal: iTunes Link SoundCloud Link Likewise, the Annals of Emergency Medicine Journal Club has published several monthly installments: Predicting Outcomes in Pediatric Pneumonia: Are We Omnipotent or Incompetent?

Hyperthermia / Hypothermia 40

Hyperthermia / Hypothermia Stroke Emergency Department Outcomes 40

Don't Forget the Bubbles

JUNE 30, 2023

The primary outcome measure was chest drain failure, i.e., retained haemothorax requiring a secondary interventional procedure. In addition, a flimsy cannula is easily dislodged during ongoing resuscitation and easily clots off. They looked at 119 adult patients from an (unspecified) number of trauma centres. to −0.5%]; P  = 0.03.).

Resuscitation 139

Resuscitation Operations Sepsis Pediatrics 139

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

Northwestern EM Blog

JANUARY 24, 2022

Due to its extremely high morbidity and mortality as well as high healthcare costs, the prompt recognition, diagnosis and resuscitation of shock is key. There is a subset of patients who, despite aggressive conventional resuscitation, have an inadequate hemodynamic response and develop refractory shock. due to inadequate access.

Anaphylaxis 52

Anaphylaxis Shock Sepsis Resuscitation 52

RebelEM

DECEMBER 19, 2022

With everything just mentioned considered, DED, in addition to other resuscitative therapies, should still be used for patients in RVF. Within the United States, due to paramedic shortages, this dual-medic setup does not exist in many EMS systems. N Engl J Med. 2022 Nov 6 PMID: 36342151 Cheskes S, et al.

EMS 52

EMS Shock CPR Resuscitation 52

Rural Doctors Net

AUGUST 30, 2013

Flooding him with crystalloid is going to dilute his clotting factors, make him hypothermic and potentially worsen outcomes. Whilst we’ve ‘re-discovered’ balanced resuscitation (first described by Cannon back after WWI), there remains some limited controversy – listen to this 2013 take from Simon Carley at St.

Burns 52

Burns Hospitals Wellness Ambulance Services 52

Taming the SRU

JUNE 6, 2023

then need further evaluation Usually with CTA imaging If normal physical exam & ABI>0.9, then need further evaluation Usually with CTA imaging If normal physical exam & ABI>0.9,

Documentation/Coding 60

Documentation/Coding Seizures Wellness Psychiatric 60