Hyperthermia

[SwansonRN]

I am curious about your patients with extreme hyperthermia. What was their Tmax? What was the cause (environmental, drugs, infection...) and did the patient survive? I have been very interested in the patho behind high fevers ever since a very challenging case I had a few weeks ago.

[limaRN, BSN, RN]

107. Unsure of cause- pt had been septic in the past but a temp that high is usually not related to an infectious process. Likely a neurogenic cause. Tylenol was ineffective. Did blood cultures, pt already on broad spectrum antibiotics. Used a cooking blanket to bring temp down. Family discontinued care a few days later and pt passed.

[KelRN215, BSN, RN]

42 Degrees Celcius... in a dying patient. She survived the immediate but died a few days or weeks later.

[Rhi007]

39 appendicitis panadol ineffective so panadeine forte and NSAIDs given to relieve pain and inflammation

[dah doh, BSN, RN]

108. Septic. Unknown cause. Family withdrew care.

[K+MgSO4, BSN]

40.7 C

Perfed appendix waiting on surgery. Paracetomol, NSAIDs, Prthadine to stop the rigors, tepid sponging, Vanc and lincomycin. 02 and IV fluids.

Finally got to theatre and 10L NS washout and an overnight in ICU and he was back on the ward with a laporotmy scar. discharged

[RNperdiem, RN]

A patient had pneumonia. After her bronchoscopy we watched her temperature rise (she had her temperature monitored with a foley temperature) from 38.5 to 41.1 It took a while for the IV tylenol to get delivered, so I used ice packs.

The RT said that sometimes patients decompensate after bronchoscopies.

[nurseprnRN, BSN, RN]

Young male who was involved in a forest fire fighting scene, heat stroke. Not burned at all, but had had a temp of 108+F when brought in to the ER. We, the critical care transport team, arrived at the small community hospital to take him to our big university shop about four hours later. He was bleeding everywhere, as the hyperthermia had pretty well cooked his platelets and other proteins. They did get him cooled but he was a mess. We kept trying but couldn't stabilize him before transport so we finally just said, the hell with it, let's just boogie outta here and get him home. We got him to our place but by then he looked like someone with Ebola, bleeding from absolutely everywhere-- eyes, mouth, gut, urine, nose, ears, IV sites, the works ... he was dead about ten hours later, not a mark on him except the IV sites.

[SwansonRN]

GrnTea, what a devastating way to die. Mine was around 42-43. Sickest patient I have ever seen

[rn/writer, RN]

107. Unsure of cause- pt had been septic in the past but a temp that high is usually not related to an infectious process. Likely a neurogenic cause. Tylenol was ineffective. Did blood cultures, pt already on broad spectrum antibiotics. Used a cooking blanket to bring temp down. Family discontinued care a few days later and pt passed.

I hope you meant "cooling." Seems like cooking was already happening.

[limaRN, BSN, RN]

Hahaha yes. A cooking blanket Would probably be bad. Darn auto correct.

[SionainnRN]

In the trauma ICU had a pt with a temp of 104, purely from the head injury. Meds wouldn't work so we packed him in ice. Ran into them a few months later and the wife reminded me that I gave him snow balls!!