ICU Cases · Post-cardiac arrest care
Hot case — the bedside: fever and shivering at 24 hours post-arrest
A CICM hot case — the bedside management of the post-arrest fever and the shivering. Tests the TTM2 principle (the fever is the enemy), the shivering control (the BSAS, the sedation, the counter-warming), and the target (the normothermia 37.5 to 37.8).
On this page
Study tools
Target exams
CICMFFICMEDIC
Prompt
At the bedside of a comatose post-arrest patient at 24 hours, whose temperature has risen to 38.5 degrees with shivering. Assess and manage.
Presentation
You are taken to the bedside of a comatose post-arrest patient at 24 hours after the ROSC. The nurse reports that the core temperature has risen to 38.5 degrees C, and the patient is shivering (the obvious tremor of the upper limbs, the diaphoresis).[2]
References2ShowHide
- [1]Dankiewicz J, Cronberg T, Lilja G, et al. Hypothermia versus Normothermia after Out-of-Hospital Cardiac Arrest (TTM2). New England Journal of Medicine, 2021.PMID 34133859
- [2]Bersten AD, Soni N (eds) Oh's Intensive Care Manual. 8th edition, Elsevier, 2018.