Podcast 786: Smiling Death
Emergency Medical Minute31 Mai 2022

Podcast 786: Smiling Death

Contributor: Nick Hatch, MD

Educational Pearls:

  • "Smiling Death" describes the prehospital phenomenon of a person who is happy to be extricated from an extended period of crush injury, but dies suddenly soon after the rescue.
  • Smiling Death is caused by Crush Syndrome. Crush Syndrome begins when large areas of tissue are damaged by compression and subsequent impeded blood flow. Resultant cell death is followed by release of myoglobin and efflux of electrolytes including potassium. Upon removal of the crushing force, high levels of potassium enter circulation and cause cardiac arrhythmias leading to sudden death.
  • Prevention measures include aggressive hydration using normal saline before extrication. An acceptable starting rate is 1L per hour, but providers should take patient status into consideration and titrate appropriately.
  • Standard techniques for controlling hyperkalemia by intracellular shifting may be less effective. Early dialysis may be useful.

References

Gonzalez D. Crush syndrome. Crit Care Med. 2005;33(1 Suppl):S34-S41. doi:10.1097/01.ccm.0000151065.13564.6f

Better OS. Rescue and salvage of casualties suffering from the crush syndrome after mass disasters. Mil Med. 1999;164(5):366-369.

Summarized by Kirsten Hughes, MS4 | Edited by John Spartz MS4 & Erik Verzemnieks, MD

The Emergency Medical Minute is excited to announce that we are now offering AMA PRA Category 1 credits™ via online course modules. To access these and for more information, visit our website at https://emergencymedicalminute.org/cme-courses/ and create an account.

Donate to EMM today!




Episoder(1149)

Mental Health Monthly #17: Mania

Mental Health Monthly #17: Mania

Contributors: Andrew White MD - Outpatient Psychiatrist; Fellowship Trained in Addiction Psychiatry; Denver Health Travis Barlock MD - Emergency Medicine Physician; Swedish Medical Center Summary In t...

5 Okt 202340min

Podcast 871: Increased Intracranial Pressure and the Cushing Reflex

Podcast 871: Increased Intracranial Pressure and the Cushing Reflex

Contributor: Travis Barlock MD Education Pearls: The Cushing Reflex is a physiologic response to elevated intracranial pressure (ICP) Cushing's Triad: widened pulse pressure (systolic hypertensio...

2 Okt 20233min

On The Streets #15: Hydrofluoric Acid Case Review

On The Streets #15: Hydrofluoric Acid Case Review

Contributors: Kalen Abbott, MD - EM Physician and Medical Director for AirLife Denver Brendan Reiss - Flight Nurse AirLife Denver Matt Spoon - Flight Paramedic AirLife Denver Jordan Ourada - E...

29 Sep 202341min

Episode 870: Advanced Trauma Life Support (ATLS)

Episode 870: Advanced Trauma Life Support (ATLS)

Contributor: Meghan Hurley MD Educational Pearls: What is ATLS? Advanced Trauma Life Support (ATLS) is a systematic and comprehensive approach to the evaluation and management of trauma patients I...

25 Sep 20237min

Podcast 869: Shift Work

Podcast 869: Shift Work

Contributor: Meghan Hurley MD Educational Pearls: Shift work is defined as anything that takes place outside of a 9-5 schedule, not exempting day-shift medical workers Various ill effects of shift...

18 Sep 20234min

Episode 868: Airway Management in Obesity

Episode 868: Airway Management in Obesity

Contributor: Aaron Lessen MD Educational Pearls: Why is airway management more difficult in obesity? Larger body habitus causes the chest to be above the head when the patient is lying supine, creat...

11 Sep 20233min

Episode 867: Occult Scaphoid Fractures

Episode 867: Occult Scaphoid Fractures

Contributor: Nick Tsipis MD Educational Pearls: The scaphoid bone is the most proximal carpal bone just distal to the radius Fractures of the scaphoid bone are sometimes missed by plain X-rays ...

4 Sep 20234min

Podcast 866: Carbamazepine (Tegretol) Overdose

Podcast 866: Carbamazepine (Tegretol) Overdose

Contributor: Aaron Lessen MD Educational Pearls: What is Carbamazepine (Tegretol)? Carbamazepine is an anti-epileptic drug with mood-stabilizing properties that is used to treat bipolar disorder, ep...

28 Aug 20232min

Populært innen Vitenskap

fastlegen
rekommandert
tingenes-tilstand
forskningno
rss-rekommandert
rss-nysgjerrige-norge
sinnsyn
liberal-halvtime
smart-forklart
villmarksliv
vett-og-vitenskap-med-gaute-einevoll
fjellsportpodden
jss
pod-britannia
psykopoden
tomprat-med-gunnar-tjomlid
dekodet-2
aldring-og-helse-podden
nevropodden
rss-paradigmepodden