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SGEM386: Blood on Blood – Massive Transfusion Protocols in Older Trauma Patients

The Skeptics' Guide to EM

Date: December 16th, 2022 Reference: Hohle et al. Date: December 16th, 2022 Reference: Hohle et al. The transfusion tech calls to remind you that your protocol is currently under review, and asks if would you like the 1:1 or the 1:3 version of fresh-frozen plasma (FFP) to packed red blood cells (pRBC)? years ( 2 ).

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Penetrating chest trauma

Don't Forget the Bubbles

This was a randomised controlled multisite study comparing resuscitation of trauma patients requiring massive transfusion using either 1:1::1 or 1:1:2 ratios of platelets to plasma to red blood cells. A recent review was conducted on Trauma Quality Improvement Program data between 2014 and 2016. 2014 Sep;45(9):1287-95.

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Snake Bites and Children

Pediatric EM Morsels

Available from: [link] Correa JA, Fallon SC, Cruz AT, et al. Sarkar S, Sinha R, Chaudhury AR, et al. In the US, the venomous snakes include rattlesnakes , copperheads, cottonmouths/water moccasins , and coral snakes [ CDC, 2021 ] Rattlesnakes live all across the United State s Copperheads inhabit the eastern U.S. Snake Toxicity.

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ToxCard: Diethylene Glycol

EMDocs

DEG is rapidly absorbed when ingested and can reach peak plasma and brain tissue concentrations within four hours of ingestion. Metabolism of DEG adapted from Bessenhofer, et al. References: Abubukar et al. Nelson, et al. Conklin, Laura, et al. 6, 1 June 2014, pp. Schier, Capt. McGraw Hill, 2019. JAMA , vol.

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Resident Journal Review: Massive Transfusion Protocols (MTPs) in Traumatic Hemorrhage

AAEM RSA

2,3 Here we examine some of the evidence behind the various components of MTPs, specifically calcium and factor VIIa, and the ratios in which the main products of red blood cells, plasma, and platelets should be administered. Holcomb JB, Tilley BC, Baraniuk S, et al. Cornelius B, Ferrell E, Kilgore P, et al. 2020;88(5):383-9.

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Postpartum Hemorrhage: The Chapter We Skipped.

FOAMfrat

Moreover, LTOWB also allows us to administer platelets and plasma, in addition to red cells, to promote clotting and homeostasis. If you don't have access to LTOWB and are administering component therapies such as PRBCs or plasma, this is still incredible and I highly encourage it! Minino AM, Heron MP, Murphy SL, et al.

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Utility of D-dimer Testing in Special Populations

EMDocs

Acute Aortic Dissection (AAD) A meta-analysis found that plasma D-dimer level <500 ng/mL is useful for identifying patients who are unlikely to have an AAD and do not require further aortic imaging. doi:10.4103/1947-2714.143278 van der Pol LM, Tromeur C, Bistervels IM, et al. x Douma RA, le Gal G, Söhne M, et al.

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