How to Be Cool

​A 27-year-old man with an unknown past medical history presented with altered mental status. Bystanders found him on the sidewalk acting strangely, according to EMS. The patient was drowsy with incomprehensible speech on arrival. He was diaphoretic, tachycardic, and combative. No signs of trauma were noted. His heart rate was 130 bpm, blood pressure 169/90 mm Hg, respiratory rate 30 bpm, SPO2 98% on room air, and temperature 105.3°F. His blood glucose was 150. The patient continued to be minimally responsive.​Etiologies of HyperthermiaNeuroleptic malignant syndromeSerotonin syndromeAnticholinergic syndromeSympathomimeticHeat strokeBaclofen withdrawalThyroid stormSeizuresOther drugs: salicylates, 2,4-dinitrophenol Malignant hyperthermiaInfectionComplications Associated with HyperthermiaHyperthermia is generally considered to be body temperatures greater than 104.0°F. Prolonged hyperthermia is associated with high morbidity and mortality. Complications include altered mental status, rhabdomyolysis, multisystem organ failure, DIC, and death. (Curr Opin Pediatr 2004;16[2]:211.)Cooling Drug-Induced Hyperthermic PatientsYou must stop the psychomotor agitation for patients with hyperthermia. (Am J Health Syst Pharm 2013;70[1]:34.) Treatment may include benzodiazepines and paralytics if agitation is still severe. Some causes of hyperthermia may have specific antidotes such as physostigmine for anticholinergic syndrome and dantrolene for malignant hyperthermia. (Am ...
Source: The Tox Cave - Category: Emergency Medicine Tags: Blog Posts Source Type: blogs