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Accidental Hypothermia Management

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1. CRACKCast E140 – Accidental Hypothermia

airway management should be performed if indicated, since the risk of triggering a malignant arrhythmia is low. Highly recommend checking out this figure as it covers all priorities: If you want some excellent summaries of Dr. Doug Brown’s work regarding accidental hypothermia in the prehospital setting check out: This post was created and copyedited by Dillan Radomske ( ) (Visited 1,907 times, 1 visits today) Dillan Radomske Dillan Radomske is an Emergency Medicine resident at the University (...) CRACKCast E140 – Accidental Hypothermia CRACKCast E140 – Accidental Hypothermia - CanadiEM CRACKCast E140 – Accidental Hypothermia In , , by Dillan Radomske January 2, 2018 This episode of CRACKCast covers Rosen’s Chapter 132, Accidental Hypothermia. Hypothermic patients will appear in the ED at any time and in any season. After listening to this podcast, you will be able to systematically approach these patients with ease. Shownotes: Rosen’s in Perspective Accidental hypothermia has been

2018 CandiEM

2. Managing accidental hypothermia: a UK-wide survey of prehospital and search and rescue providers. (Abstract)

Managing accidental hypothermia: a UK-wide survey of prehospital and search and rescue providers. The management of hypothermic casualties is a challenge faced by all prehospital and search and rescue (SAR) teams. It is not known how the practice of these diverse teams compare. The aim of this study was to review prehospital hypothermia management across a wide range of SAR providers in the UK.A survey of ground ambulances (GAs), air ambulances (AAs), mountain rescue teams (MRTs, including (...) and GAs, 93% of LRTs, 80% of CRTs, 75% of MRTs and 31% of LLOs. The favoured anatomical site for temperature measurement was tympanic. Protocols for packaging hypothermic casualties were reported by 73% of services.This survey describes current practice in prehospital hypothermia management, comparing the various methods used by different teams, and provides a basis to direct further education and research.© Author(s) (or their employer(s)) 2018. No commercial re-use. See rights and permissions

2018 Emergency Medicine Journal

3. Accidental Hypothermia Clinical Practice Guideline for British Columbia

Accidental Hypothermia Clinical Practice Guideline for British Columbia Version 1.03: December 9, 2016 Page 1 of 15 Accidental Hypothermia Clinical Practice Guideline for British Columbia Accidental Hypothermia – Evaluation, Triage & Management Version 1.03: December 9, 2016 Written by: Dr. Doug Brown & BC Accidental Hypothermia Working Group Scope The objective of this guideline is to improve the efficiency and effectiveness of the management of accidental hypothermia in British Columbia (...) . The use of simplified clinical staging, suggested treatment guidelines as well as triage and transportation algorithms has the potential to decrease morbidity and mortality of patients with accidental hypothermia in British Columbia. 1,2 Target Population Adults and children with a core temperature below 35 o C presenting to emergency departments, physicians’ offices, walk-in clinics, nursing stations and pre-hospital care providers. Applicable Diagnositic Codes: ICD 10 T68 Evaluation and Diagnosis

2016 Clinical Practice Guidelines and Protocols in British Columbia

4. Accidental Hypothermia Management

Accidental Hypothermia Management Accidental Hypothermia Management Toggle navigation Brain Head & Neck Chest Endocrine Abdomen Musculoskeletal Skin Infectious Disease Hematology & Oncology Cohorts Diagnostics Emergency Findings Procedures Prevention & Management Pharmacy Resuscitation Trauma Emergency Procedures Ultrasound Cardiovascular Emergencies Lung Emergencies Infectious Disease Pediatrics Neurologic Emergencies Skin Exposure Miscellaneous Abuse Cancer Administration 4 Accidental (...) Hypothermia Management Accidental Hypothermia Management Aka: Accidental Hypothermia Management , Hypothermia Management From Related Chapters II. Precautions is preferred management for severe (<28 C) or severe cardiac dysrhythmia (e.g. ) See for related complications (e.g. ) Anticipate malignant arrhythmia on rewarming (rescue collapse) Avoid measures that provoke arrhythmias (e.g. jostling or moving patient) Be prepared for recurrent arrhythmia Continuous monitoring and pads kept in place Most non

2018 FP Notebook

5. Impact of rewarming rate on the mortality of patients with accidental hypothermia: analysis of data from the J-Point registry. Full Text available with Trip Pro

Impact of rewarming rate on the mortality of patients with accidental hypothermia: analysis of data from the J-Point registry. Accidental hypothermia (AH) is defined as an involuntary decrease in core body temperature to < 35 °C. The management of AH has been progressing over the last few decades, and numerous techniques for rewarming have been validated. However, little is known about the association between rewarming rate (RR) and mortality in patients with AH.This was a multicentre chart (...) review study of patients with AH visiting the emergency department of 12 institutions in Japan from April 2011 to March 2016 (Japanese accidental hypothermia network registry, J-Point registry). We retrospectively registered patients using the International Classification of Diseases, Tenth Revision code T68: 'hypothermia'. We excluded patients whose body temperatures were unknown or ≥ 35 °C, who could not be rewarmed, whose rewarmed temperature or rewarming time was unknown, those aged < 18 years

2019 Scandinavian journal of trauma, resuscitation and emergency medicine

6. Therapeutic management of severe hypothermia with veno-arterial ECMO: where do we stand? Case report and review of the current literature. Full Text available with Trip Pro

Therapeutic management of severe hypothermia with veno-arterial ECMO: where do we stand? Case report and review of the current literature. Severe accidental hypothermia is associated with high morbidity and mortality. Veno-arterial extracorporeal membrane oxygenation (VA-ECMO) provides an efficient rewarming method with complete cardiopulmonary support. The use of VA-ECMO for this indication has greatly improved the vital and functional prognosis of patients.We report a case of a 46-year-old (...) patient who was treated for severe hypothermia with a temperature of 22.4 °C along with initial cardiac arrest, whose progression was favorable after the implementation of VA-ECMO support. Two months after initial cardiac arrest, the patient was reassessed and showed signs of complete recovery with regard to his mental and physical capacities.The recent international publications and groups of experts recommend the use of VA ECMO as the gold standard therapy to treat severe hypothermia. Therefore

2020 Scandinavian journal of trauma, resuscitation and emergency medicine

7. Profound Accidental Hypothermia: Systematic Approach to Active Recognition and Treatment Full Text available with Trip Pro

(resuscitation times from arrest to extracorporeal membrane oxygenation implantation ranged 107-345 minutes). Seven patients died, and the remaining 14 have been rewarmed with the restoration of hemodynamic stability. Systematic approach to active recognition and treatment of profound accidental hypothermia patients, on the basis of HC cooperation with emergency medical services, enables advanced management with good outcomes, especially in patients with cardiac arrest. (...) Profound Accidental Hypothermia: Systematic Approach to Active Recognition and Treatment We sought to organize a functional system of recognition and advanced treatment of hypothermic patients with extracorporeal rewarming as a treatment option. All patients with suspected hypothermia are consulted with the hypothermia coordinator (HC), whose role is to provide expertise on hypothermia recognition and treatment to all rescue and medical services. Patients with Swiss staging system

2017 Asaio Journal

8. Is the prehospital use of active warming dangerous for patients with accidental hypothermia?

Is the prehospital use of active warming dangerous for patients with accidental hypothermia? Print | PDF PROSPERO This information has been provided by the named contact for this review. CRD has accepted this information in good faith and registered the review in PROSPERO. The registrant confirms that the information supplied for this submission is accurate and complete. CRD bears no responsibility or liability for the content of this registration record, any associated files or external (...) , see the and to pre-clinical meta-analysis. Example: Because of the exploratory nature of animal studies, a random effects model will be used to account for anticipated heterogeneity. ">Effect models Example: Heterogeneity will be assessed using the (residual) I2 and adjusted R2 statistics. ">Heterogeneity For further guidance please refer to the and to pre-clinical meta-analysis. Example: Whenever a control group serves more than one experimental group, we will correct the total number of control

2019 PROSPERO

9. Measurement of Serum Potassium Rate During Accidental Hypothermia.

Measurement of Serum Potassium Rate During Accidental Hypothermia. Measurement of Serum Potassium Rate During Accidental Hypothermia. - Full Text View - ClinicalTrials.gov Hide glossary Glossary Study record managers: refer to the if submitting registration or results information. Search for terms x × Study Record Detail Saved Studies Save this study Warning You have reached the maximum number of saved studies (100). Please remove one or more studies before adding more. Measurement of Serum (...) : University Hospital, Grenoble Collaborators: University Grenoble Alps Emergency Department, University Hospital Vaudois, Lausanne Emergency Department, Hospital of Valais, Sion Information provided by (Responsible Party): University Hospital, Grenoble Study Details Study Description Go to Brief Summary: Serum Potassium Rate (PR) is a key indicator for medical management of patients with accidental hypothermia particularly for hypothermia related cardiac arrest (CA). Experts recommend a cut-off value

2017 Clinical Trials

10. Accidental Hypothermia

Accidental Hypothermia Accidental Hypothermia Toggle navigation Brain Head & Neck Chest Endocrine Abdomen Musculoskeletal Skin Infectious Disease Hematology & Oncology Cohorts Diagnostics Emergency Findings Procedures Prevention & Management Pharmacy Resuscitation Trauma Emergency Procedures Ultrasound Cardiovascular Emergencies Lung Emergencies Infectious Disease Pediatrics Neurologic Emergencies Skin Exposure Miscellaneous Abuse Cancer Administration 4 Accidental Hypothermia Accidental (...) Hypothermia Aka: Accidental Hypothermia , Hypothermia , Hypothermia due to Exposure From Related Chapters II. Definition Core <95 F (35 C) III. Epidemiology U.S. Deaths: 1500 per year (50% are over age 65 years) IV. Risk Factors Extremes of age or other Comorbid illness Poor Homeless V. Causes See VI. Mechanism Radiative heat loss (50% of heat loss) Majority of radiative heat loss via head (60%) Conductive heat loss (2-3% of heat loss) Wet clothing: Heat loss increases x5 Cold water immersion: Heat loss

2018 FP Notebook

11. The prehospital management of hypothermia - An up-to-date overview. (Abstract)

The prehospital management of hypothermia - An up-to-date overview. Accidental hypothermia concerns a body core temperature of less than 35°C without a primary defect in the thermoregulatory system. It is a serious threat to prehospital patients and especially injured patients, since it can induce a vicious cycle of the synergistic effects of hypothermia, acidosis and coagulopathy; referred to as the trauma triad of death. To prevent or manage deterioration of a cold patient, treatment (...) of hypothermia should ideally begin prehospital. Little effort has been made to integrate existent literature about prehospital temperature management. The aim of this study is to provide an up-to-date systematic overview of the currently available treatment modalities and their effectiveness for prehospital hypothermia management.Databases PubMed, EMbase and MEDLINE were searched using the terms: "hypothermia", "accidental hypothermia", "Emergency Medical Services" and "prehospital". Articles

2017 Injury

12. Hypothermia

or #4) Loading history... Population: Intervention: Comparison: Outcome: Population: Intervention: Latest & greatest articles for hypothermia The Trip Database is a leading resource to help health professionals find trustworthy answers to their clinical questions. Users can access the latest research evidence and guidance to answer their clinical questions. We have a large collection of systematic reviews, clinical guidelines, regulatory guidance, clinical trials and many other forms of evidence (...) approximately 310,000 deaths before the patient reaches the hospital Emergency Department each year in the United States. Sudden cardiac death occurs more often in patients who are recovering from a heart attack or whose hearts have a reduced ability to pump 2009 5. Therapeutic Hypothermia after Cardiac Arrest ANZCOR Guideline 11.8 January 2016 Page 1 of 8 ANZCOR Guideline 11.8 – Targeted Temperature Management (TTM) after Cardiac Arrest Summary This guideline provides advice on targeted temperature

2018 Trip Latest and Greatest

13. Management of Poisoning

of an anaphylactoid reaction does not preclude the use of N-acetylcysteine on another occasion, if indicated (pg 112). Grade D, Level 316 B Methionine can be considered as an alternative antidote for paracetamol poisoning, especially in the setting of known allergy to N-acetylcysteine (pg 112). Grade B, Level 1+ Management of non-accidental toxic ingestions D Admission is recommended, irrespective of levels for non-accidental ingestion. Serum levels must be tested. Multi-drug poisoning should be considered (pg (...) 112). Grade D, Level 4 ED/hospital management of accidental ingestions Acute single dose toxic ingestion Asymptomatic patients B If 8 hours: Commence IV N-Acetylcysteine (do not wait for levels) (pg 113). • Obtain paracetamol levels as soon as possible. • Obtain ALT/AST stat and repeat at the end of N-acetylcysteine infusion or every 12 hours, whichever comes ? rst. • If the serum paracetamol level is subsequently found to be below the normogram line, N-acetylcysteine may be ceased; if above

2020 Ministry of Health, Singapore

14. Extracorporeal Life Support for Refractory Cardiac Arrest from Accidental Hypothermia: A 10-Year Experience in Edinburgh. (Abstract)

Extracorporeal Life Support for Refractory Cardiac Arrest from Accidental Hypothermia: A 10-Year Experience in Edinburgh. Cardiac arrest caused by accidental hypothermia is a rare phenomenon with a significant mortality rate if untreated. The consensus is that these patients should be rewarmed with extracorporeal life support (ECLS) with the potential for excellent survival and neurologic outcomes. However, given the lack of robust data and clinical trials, the optimal management (...) impairment.Our case series shows the remarkable salvageability of patients suffering prolonged cardiac arrest caused by accidental hypothermia, particularly in the absence of asphyxia, trauma, or severe hyperkalemia. ECLS is a safe and effective rewarming treatment and should be used to aggressively manage this patient group.Copyright © 2016 Elsevier Inc. All rights reserved.

2016 Journal of Emergency Medicine

15. Severe accidental hypothermia treated with cardiopulmonary bypass Full Text available with Trip Pro

Severe accidental hypothermia treated with cardiopulmonary bypass This case report describes the successful treatment of severe accidental hypothermia with cardiopulmonary bypass (CPB). A known intravenous drug misuser aged 22 years was found to be unresponsive at his home (winter evening) with a Glasgow coma scale of 3/15. In the ambulance, the patient went into cardiac arrest, cardiopulmonary resuscitation being started. On arrival to the emergency department, he had a core body temperature (...) of 27°C which was refractory to conservative management. He underwent femoro-femoral CPB, which was successful in rewarming the patient slowly. The patient was discharged home with no neurological deficit 10 days later.2016 BMJ Publishing Group Ltd.

2016 BMJ case reports

16. Accidental hypothermia-an update : The content of this review is endorsed by the International Commission for Mountain Emergency Medicine (ICAR MEDCOM). Full Text available with Trip Pro

Accidental hypothermia-an update : The content of this review is endorsed by the International Commission for Mountain Emergency Medicine (ICAR MEDCOM). This paper provides an up-to-date review of the management and outcome of accidental hypothermia patients with and without cardiac arrest.The authors reviewed the relevant literature in their specialist field. Summaries were merged, discussed and approved to produce this narrative review.The hospital use of minimally-invasive rewarming for non (...) triage, transport and treatment as well as in-hospital management, including detailed criteria and protocols for the use of ECLS and post-resuscitation care.Based on new evidence, additional clinical experience and clearer management guidelines and documentation, the treatment of accidental hypothermia has been refined. ECLS has substantially improved survival and is the treatment of choice in the patient with unstable circulation or cardiac arrest.

2016 Scandinavian journal of trauma, resuscitation and emergency medicine

17. Case Report: Hypothermia and Traumatic Arrest in the Game of Thrones

is Coming”. HBO Canada. Game of Thrones S05E10. This post was copy-edited and uploaded by and . References 1. Lockey D, Crewdson K, Davies G. Traumatic cardiac arrest: who are the survivors? Ann Emerg Med . 2006;48(3):240-244. [ ] 2. ATLS S, American C, International A. Advanced trauma life support (ATLS®): the ninth edition. J Trauma Acute Care Surg . 2013;74(5):1363-1366. [ ] 3. Kempainen R, Brunette D. The evaluation and management of accidental hypothermia. Respir Care . 2004;49(2):192-205. [ ] 4 (...) Case Report: Hypothermia and Traumatic Arrest in the Game of Thrones Game of Thrones Case Report - Hypothermia in Traumatic Cardiac Arrest Resuscitation Case Report: Hypothermia and Traumatic Arrest in the Game of Thrones In by Will Wu August 22, 2017 Be warned: this case report contains spoilers for Game of Thrones Season 5 and 6. Patient Presentation and History A 21-year-old man, by the name of Lord Commander Jon Snow, was discovered unconscious and unresponsive after receiving multiple stab

2017 CandiEM

18. Accidental hypothermia in Poland – estimation of prevalence, diagnostic methods and treatment. Full Text available with Trip Pro

Accidental hypothermia in Poland – estimation of prevalence, diagnostic methods and treatment. The incidence of hypothermia is difficult to evaluate, and the data concerning the morbidity and mortality rates do not seem to fully represent the problem. The aim of the study was to estimate the actual prevalence of accidental hypothermia in Poland, as well as the methods of diagnosis and management procedures used in emergency rooms (ERs).A specially designed questionnaire, consisting of 14 (...) is rarely conducted in intensive care wards and extracorporeal rewarming techniques are not used. It may be expected that personnel education and the development of management procedures will brighten the prognosis and increase the survival rate in accidental hypothermia.

2015 Scandinavian journal of trauma, resuscitation and emergency medicine

19. Accidental Hypothermia Management

Accidental Hypothermia Management Accidental Hypothermia Management Toggle navigation Brain Head & Neck Chest Endocrine Abdomen Musculoskeletal Skin Infectious Disease Hematology & Oncology Cohorts Diagnostics Emergency Findings Procedures Prevention & Management Pharmacy Resuscitation Trauma Emergency Procedures Ultrasound Cardiovascular Emergencies Lung Emergencies Infectious Disease Pediatrics Neurologic Emergencies Skin Exposure Miscellaneous Abuse Cancer Administration 4 Accidental (...) Hypothermia Management Accidental Hypothermia Management Aka: Accidental Hypothermia Management , Hypothermia Management From Related Chapters II. Precautions is preferred management for severe (<28 C) or severe cardiac dysrhythmia (e.g. ) See for related complications (e.g. ) Anticipate malignant arrhythmia on rewarming (rescue collapse) Avoid measures that provoke arrhythmias (e.g. jostling or moving patient) Be prepared for recurrent arrhythmia Continuous monitoring and pads kept in place Most non

2015 FP Notebook

20. Management of acute (fulminant) liver failure

and hyperacute liver failure (which have similar phenotype and clinical course), and subacute liver failure (which presents with a dif- ferent clinical course). Separation of these two groups should be considered in future guidance, regarding prognosis and clinical management pathways. Another prerequisite for de?ning cases of ALF is the absence of previous severe ?brotic or cirrhotic chronic liver disease. Speci?c exceptions are the acute de novo presentation of autoimmune hepatitis and Budd-Chiari syndrome (...) Management of acute (fulminant) liver failure EASL Clinical Practical Guidelines on the management of acute (fulminant) liver failure q European Association for the Study of the Liver ? Summary The term acute liver failure (ALF) is frequently applied as a gen- eric expression to describe patients presenting with or develop- ing an acute episode of liver dysfunction. In the context of hepatological practice, however, ALF refers to a highly speci?c andraresyndrome

2017 European Association for the Study of the Liver

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