Podcast 786: Smiling Death

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(1145)

Episode 959: The KLM Flight Disaster and Lessons in Healthcare Communication

Episode 959: The KLM Flight Disaster and Lessons in Healthcare Communication

Contributor: Taylor Lynch, MD Educational Pearls: The KLM Flight Disaster, also known as the Tenerife Airport Disaster, occurred on 27 March 1977. It involved the collision of two Boeing 747 passenger...

2 Jun 20256min

Episode 958: Intranasal Fentanyl

Episode 958: Intranasal Fentanyl

Contributor: Aaron Lessen, MD Educational Pearls: How do we take care of kids in severe pain? There are many non-pharmacologic options for pain (i.e. ice, elevation) as well as more conventional medi...

26 Mai 20251min

Episode 957: Cardiac Asthma

Episode 957: Cardiac Asthma

Contributor: Travis Barlock, MD Educational Pearls: Wheezing is classically heard in asthma and COPD, but it can be the result of a wide range of processes that cause airflow limitation Narrowed bro...

19 Mai 20253min

Episode 956: Psychedelics and Risk of Schizophrenia

Episode 956: Psychedelics and Risk of Schizophrenia

Contributor: Jorge Chalit-Hernandez, OMS3 Educational Pearls: Psychedelics are being studied for their therapeutic effects in mental illnesses, including major depressive disorder, post-traumatic str...

12 Mai 20252min

Episode 955: Cardiac Effects of COVID-19

Episode 955: Cardiac Effects of COVID-19

Contributor: Ricky Dhaliwal, MD Educational Pearls: What factors are considered in a COVID-19 infection? The viral load: Understood as the impact of SARS-CoV-2 viral particles infecting host cell tis...

5 Mai 20254min

Episode 954: Combo Rescue Inhalers - New Guidelines

Episode 954: Combo Rescue Inhalers - New Guidelines

Contributor: Aaron Lessen, MD Educational Pearls: What is a Rescue Inhaler? A rescue inhaler is a medication for people with asthma to quickly reverse the symptoms of an asthma attack.  Historical...

30 Apr 20253min

Episode 953: Penicillin Allergies

Episode 953: Penicillin Allergies

Contributor: Geoff Hogan MD Educational Pearls: Penicillin allergies are relatively uncommon despite their frequent reports 10% of the population reports a penicillin allergy but only 5% of these...

21 Apr 20252min

Episode 952: Heart Transplants

Episode 952: Heart Transplants

Contributor: Travis Barlock, MD Educational Pearls: Key clinical considerations when managing heart transplant patients due to their unique pathophysiology 1. Arrhythmias A transplanted heart i...

14 Apr 20253min

Populært innen Vitenskap

fastlegen
tingenes-tilstand
rekommandert
jss
smart-forklart
vett-og-vitenskap-med-gaute-einevoll
rss-rekommandert
forskningno
sinnsyn
villmarksliv
fjellsportpodden
rss-nysgjerrige-norge
rss-paradigmepodden
pod-britannia
aldring-og-helse-podden
nordnorsk-historie
diagnose
tidlose-historier
tomprat-med-gunnar-tjomlid
rss-overskuddsliv