Crit Care Resusc
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A 52-year-old woman presented with severe accidental hypothermia associated with out-of-hospital cardiac arrest after a polypharmacy overdose. Deep hypothermia developed while she lay unconscious, with a split-system air-conditioning unit rapidly cooling the confined area of her bedroom. ⋯ The neuroprotective role of accidental hypothermia is reviewed, as are the guidelines for resuscitation in this setting. We conclude that hypothermia must be considered even in unlikely circumstances, such as the Queensland summer, when ambient temperatures are high.
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Clozapine-induced neuroleptic malignant syndrome (NMS) may present differently from NMS associated with traditional antipsychotic agents, with fewer clinical features, particularly fewer extrapyramidal manifestations. The risk of developing NMS with clozapine does not appear dose-related. In half of cases, it occurs within 2 weeks of beginning clozapine therapy, but it can develop at any stage, especially with long-term use. We describe a patient who presented with atypical NMS after more than 10 years of clozapine treatment, and who was safely re-challenged with the same drug.
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To determine the survival and outcome of elderly patients admitted to the intensive care unit at Cairns Base Hospital. ⋯ Elderly patients admitted to the ICU have high mortality. As age increases, mortality increases. Elderly survivors can expect a lower quality of life after an ICU admission, although on average the difference is not great.
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The value of echocardiography in the critically ill patient is well established, yet applying the modality to patients who could benefit presents considerable logistical challenges. Central is a lack of readily available, trained operators. Although many intensive care specialists and trainees are keen to fill this gap, there are numerous hurdles to obtaining the necessary training. ⋯ It is important that, after training, intensivists can be readily credentialed in their home institutions. The intensive care community needs to determine the vehicle for training and credentialling in echocardiography. This could be achieved solely by bodies representing intensive care or in collaboration with the Australasian Society for Ultrasound in Medicine.