Cardiac arrest secondary to environmental hypothermia: Incidence and outcomes in an urban emergency department in the Upper Midwestern United States.

Objectives: Data describing hypothermic cardiac arrest (HCA) outcomes predominantly originate from patients involved in wilderness accidents. We describe the incidence and outcomes of HCA in an urban environment, with a subgroup analysis of patients with witnessed HCA in the prehospital or emergency department (ED) setting.

Methods: We completed a retrospective, single center cohort analysis of consecutive adult patients with environmental exposure and core body temperature ≤ 32 °C.

Extracorporeal membrane oxygenation versus conventional rewarming for severe hypothermia in an urban emergency department.

Background: Severe hypothermia (core body temperature < 28°C) is life-threatening and predisposes to cardiac arrest. The comparative effectiveness of different active internal rewarming methods in an urban U.S.

Non-invasive zero-heat-flux technology compared with traditional core temperature measurements in the emergency department.

Introduction: Core temperatures (T) are often invasive, and can be underutilized. Peripheral temperatures are easier to obtain, but are often less accurate. A zero-heat-flux thermometer (ZHF) is a non-invasive method to obtain core temperatures (T), and has been accurate when compared to T in the operating room.

Screening for QT Prolongation in the Emergency Department: Is There a Better "Rule of Thumb?".

Introduction: Identification of QT prolongation in the emergency department (ED) is critical for appropriate monitoring, disposition, and treatment of patients at risk for torsades de pointes (TdP). Unfortunately, identifying prolonged QT is not straightforward. Computer algorithms are unreliable in identifying prolonged QT.

Utility of plain abdominal radiography in adult ED patients with suspected constipation.

Background: Abdominal radiographs are often obtained in ED patients with suspected constipation, although their utility in adults is not well understood. We sought to compare ED management when an abdominal radiograph is and is not obtained.

Methods: We performed a retrospective chart review study of adult ED patients with a chief complaint of constipation from 2010 through 2016.

Emergency Medicine Resident Shift Work Preferences: A Comparison of Resident Scheduling Preferences and Recommended Schedule Design for Shift Workers.

Background: Shift work can negatively impact an individual's health, wellness, and quality of work. Optimal schedule design can mitigate some of these effects. The American College of Emergency Physicians has published schedule design guidelines to increase wellness and longevity in the field, but these guidelines are difficult to apply to emergency medicine (EM) residents given their high shift burdens and other scheduling constraints.

Endovascular rewarming in the emergency department for moderate to severe accidental hypothermia.

Background: Endovascular temperature control catheters can be utilized for emergent rewarming in accidental hypothermia. The purpose of this study was to compare patients with moderate to severe hypothermia rewarmed with an endovascular temperature control catheter versus usual care at our institution.

Methods: We conducted a retrospective, observational cohort study of patients with moderate to severe accidental hypothermia (core body temperature less than 32°C) in the Emergency Department of an urban, tertiary care medical center.

Evidence-Based Management Of Accidental Hypothermia In The Emergency Department.

Accidental hypothermia is defined as an unintentional drop in core body temperature below 35°C. It can present in any climate and in any season, as it is not always a result of environmental exposure; underlying illnesses or coexisting pathology can play important roles. Although there is some variability in clinical presentation, hypothermia produces a predictable pattern of physiologic responses and clinical manifestations, and effective treatment has yielded many impressive survival case reports.