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In statistics, several tools are used to interpret the data. Measures of central tendency represent the characteristics of the data, such as mean, median, and mode. Additionally, measures of variance like standard deviation and range are used to find the spread of data from the mean. Relative standing measures the distance between data locations. Commonly used measures of relative standings are percentile, z score, and quartiles.
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Esophageal Heat Transfer for Patient Temperature Control and Targeted Temperature Management
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Shivering Treatments for Targeted Temperature Management: A Review.

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  • 1Questions or comments about this article may be directed to Akash Jain, MBBS, at akashjain2019@gmail.com. Medical Officer, Government of Rajasthan, India. Maria Gray, MA RN, is Vice President for Clinical Services, Attune Medical, Chicago, IL. Stephanie Slisz, BSN RN, is Senior Clinical Specialist, Attune Medical, Chicago, IL. Joseph Haymore, DNP ACNP, is Senior Nurse Practitioner and Advanced Practice Provider Research Director, Neurocritical Care Intensive Care Unit, University of Maryland Medical Center, Baltimore, Maryland. Neeraj Badjatia, MD, is Professor of Neurology and Vice Chair for Hospital Operations, Department of Neurology, University of Maryland School of Medicine and R Adams Cowley Shock Trauma Center, Baltimore, MD. Erik Kulstad, MD MS, is Associate Professor, Department of Emergency Medicine, University of Texas Southwestern Medical Center, Dallas, TX.

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Summary
This summary is machine-generated.

Shivering during targeted temperature management (TTM) requires proactive treatment. A stepwise approach, starting with nonpharmacologic methods and specific medications before cooling, is recommended to minimize shivering effectively.

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Area of Science:

  • Critical care medicine
  • Neurology
  • Thermoregulation

Background:

  • Shivering is a frequent complication during targeted temperature management (TTM).
  • Effective shivering control is crucial but can be challenging for clinicians unfamiliar with current strategies.

Purpose of the Study:

  • To review existing literature on treatments for shivering during TTM.
  • To propose an evidence-based, recommended approach for managing shivering.

Main Methods:

  • Comprehensive literature search of PubMed/MEDLINE and Google Scholar.
  • Keywords included "shivering treatment," "therapeutic hypothermia," "core temperature modulation devices," and "targeted temperature management."

Main Results:

  • Nonpharmacologic methods offer a low adverse effect profile but may not fully control shivering.
  • Pharmacologic agents can effectively manage shivering, but require balancing efficacy against potential adverse effects.

Conclusions:

  • Initiate shivering control before or during the initiation of therapeutic hypothermia.
  • Employ a stepwise escalation strategy, starting with acetaminophen, buspirone, magnesium sulfate, and skin counterwarming, guided by a shivering scale.
  • Prioritize minimizing sedation and reserve paralytics as a last resort.