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EM@3AM: Hyperthermia

EMDocs

As you attempt to examine the patient, he has a generalized, tonic-clonic seizure. A 12-lead EKG shows sinus tachycardia but is otherwise normal. What is your diagnosis, and what are your next steps in evaluation and management? 1 Fever is usually < 40C. 1 Fever is usually < 40C. Temps greater than 41.5C Temps greater than 41.5C

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The Latest in Critical Care, 1/29/24 (Issue #27)

PulmCCM

Patients presenting with hypothermia should not be warmed too quickly (allowing their temperature to increase by <0.5°C/hour). EEG Advised, to Rule Out Nonconvulsive Seizures Nonconvulsive seizures are occasionally present in comatose patients after cardiac arrest, undetectable without testing. °C/hour).

CPR 115
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Grand Rounds Recap 3.20.24

Taming the SRU

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

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SGEM#199: Therapeutic Hypothermia – What is it Good For?

The Skeptics' Guide to EM

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. Case: Johnny is a 22-year-old male patient who presents to the emergency department via EMS with a seizure.

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

EMDocs

Use of 20% intravenous lipid emulsion can be efficacious in the resuscitation of life-threatening local anesthetic toxicity, especially from bupivacaine. Flumazenil administration is associated with harm in patients who are at increased risk for seizures or dysrhythmias. COR No Benefit, LOE C-EO. COR Harm, LOE B-R. COR 1, LOE C-LD.

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2023 AHA Update on ACLS

EMDocs

Avoid routine seizure prophylaxis in adult survivors of cardiac arrest (Level 3: no benefit), but treat seizures if they occur (Level 1: strong). 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.

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Unconscious + STEMI criteria: activate the cath lab?

Dr. Smith's ECG Blog

The patient had a witnessed generalized tonic-clonic seizure leading to GCS 4. In the resuscitation room, the patient had another seizure that stopped after IV Lorazepam. Hypothermia can also produce bradycardia and J waves, with a pseudo-STEMI pattern. EMS reported an initial GCS of 8 with pupils equal and reactive.