Since it looks like the United States is about to go into total meltdown from a heat wave, I dusted off the hyperthermia chapter. This is a bit of an impromptu post, so we don't have a podcast to go along with it (we will record one eventually – Adam has more experience with the ice tarp taco than I do). So stick some bags of lactated ringers in the refrigerator, get your ice buckets ready, and, well, good luck.
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The IBCC chapter is located here.
- The podcast & comments are below.
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Josh is the creator of PulmCrit.org. He is an associate professor of Pulmonary and Critical Care Medicine at the University of Vermont.
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Thank you for the post. What is your experience/opinion regarding intravascular cooling catheters in this population?
Just had a young guy in his 30s die from heat stroke a few weeks ago in our ED. He arrested only minutes after I was consulted, but regardless all the right treatments were instituted before I arrived. Thanks for posting this, hopefully someone will read this and make use of it over the hot summer.
Thanks for this post, in our Hospital I’ve seen 2 cases this year, during the first heat wave (one “classic”, the other “exertional”); regardless all treatments dead in less than 2 hours; I would focus that temperature control must start during transport.
Sir..
Is there anything you can do to control a high grade fever occured after electrical injury. Patient is on MV. It occurs around every hour with shivering and tachycardia. Only improved by cooling temporary.
A very good article. One thing I like to add. The GASH score is also useful regarding the use of steroids.
Thank you for the fantastic overview. I was wondering about your thoughts on why in HHS the rate of decreasing glucose and hence osmolality is much higher than the chronic hypernatremia (3-8 vs 0.5-1 mmol/l/hr)?