Severe Heat Stroke Resuscitation Using a Body Bag in a Community Emergency Department.

Heat stroke can lead to severe complications such as end-organ damage and death. The primary treatment modality for heat stroke is rapid cold-water immersion to lower the patient\u27s body temperature. This typically requires a large bath to place the patient in, which may not be available in small or community emergency departments. Although rarely present in the literature, a body bag for cold-water immersion can be used if a bath is not available. Here, we present a case of a 63-year-old male who presented to the emergency department unresponsive with hyperthermia after a heat wave warning was issued. After a thorough workup and imaging, the patient was given IV saline and naloxone, which did not improve his condition. Therefore, the patient was placed in a body bag filled with cold water and ice until his body temperature reduced to 100°F, after which he was removed and closely monitored. The patient was safely discharged and only required repeat lab work three days after discharge. This case highlights a unique technique that emergency physicians can utilize in scenarios where a typical cold-water immersion setup and execution are not possible

Spontaneous Tumor Lysis Syndrome in an Adenocarcinoma of Unknown Origin.

Spontaneous tumor lysis syndrome (STLS) is a rare oncologic emergency caused by massive cancer cell lysis or necrosis without a precipitating factor. Although tumor lysis syndrome (TLS) is most commonly associated with hematologic malignancies, a small number of cases in solid tumor malignancies have been reported. We present a case of spontaneous tumor lysis syndrome in a 77-year-old female with a widely metastatic, poorly differentiated adenocarcinoma of unknown origin. She presented in distributive shock, and laboratory testing at admission revealed acute renal failure, high anion gap metabolic acidosis, hyperuricemia, hyperkalemia, hyperphosphatemia, and hypocalcemia. Rasburicase and continuous renal replacement therapy were initiated, however, her condition deteriorated. Treatment was withdrawn and she died four days after admission