A 40 year old man presents via ambulance after he was found stumbling around a park on a hot summer day. He is mumbling, not responding to questions appropriately, and very disoriented. His skin is dry and hot to touch. Rectal temperature is 106.1 F. IV access has been obtained and normal saline has been started. What is next most effective immediate treatment for cooling?
A. Rectal Acetaminophen
B. Cooling with fans and skin wetting from a spray bottle.
C. Bladder lavage.
D. Ice packs placed on axillae and groin.
E. Cardiopulmonary bypass/ ECMO.
With summer in full swing now, swimming emergencies are bound to increase. A recent surge in media coverage may have raised many questions about the phenomenon known as “dry drowning." Variations in nomenclature regarding drowning can lead to confusion and imprecise terminology. Check out this post for a quick review:
There is an estimated 1 in-flight emergency per 11,000 passengers. And with the aging of the population, the chance of you being on-board when an emergency occurs is becoming more of a possibility. Prepare yourself by knowing what will be available to you!
For some, this topic may be more bread and butter than others. Many of you may work in cold areas where you are likely to see patients with hypothermia on a regular basis, especially in the winter. Whether you work shifts in a mountainous region or are simply catching up on EM topics while studying for boards in your in you flip flops by the beach, here are a few pearls regarding patients who present with hypothermia and their management.
Helicopter emergency medical services (HEMS) offers rapid transport to trauma centers while simultaneously providing advanced prehospital care. It is through these reasons that HEMS carries a survival benefit over ground emergency medical services (GEMS). However, increasing financial burdens and aviation risks to flight crews/patients complicate the decision to transport a patient by HEMS.
Excited delirium syndrome is a pathophysiologic progression that Emergency Medicine physicians are exposed to daily. While the initial management often takes place in the pre-hospital setting, these patients are at high risk of respiratory and cardiac arrest if proper management is not continued after hitting our doors. Despite a growing awareness of excited delirium syndrome and it's associated increased risk of death, the majority of the 250 annual deaths from this entity occur while in police custody.