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Podcast 185.0: Anticoagulation Reversal

Core EM

Hosts: Joe Offenbacher, MD Audrey Bree Tse, MD [link] Download Leave a Comment Tags: Anticoagulation , Critical Care , Resuscitation Show Notes Coagulation Cascade: Algorithm for Anticoagulated Bleeding Patient in the ED: Indications for Anticoagulation Reversal: References: Baugh CW, Levine M, Cornutt D, et al. 2015 Dec 22;132(25):2412-22.

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REBEL Core Cast 108.0 – Angioedema

REBEL EM

Bradykinin Mediated Plasma globulins called kininogens release bradykinin and cause vascular permeability. Image: ( Morgan 2010 ) Features Absence of urticaria and pruritus Insidious onset (24-36 hours) ACE Inhibitors Inhibition of ACE hinders the degradation of bradykinin and can lead to idiosyncratic angioedema.

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Unstable Pelvic Trauma Patient: ED Presentations, Evaluation, and Management

EMDocs

The nuances of fracture patterns and delineating mechanically unstable pelvic fractures from stable ones is less important to the ED. This is less critical in ED management of the unstable pelvic fracture, as the optimal site for identification of rectal or vaginal tears is the operating room.

ED 54
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Trauma Resuscitation Updates

REBEL EM

JAMA 2015 [7] The PROPPR Trial 680 severely injured adult trauma patients Patients randomized to Plasma, Platelets, and PRBCs in a 1:1:1 ratio vs 1:1:2 ratio No difference in overall mortality at 24 hrs BUT 1:1:1 achieved hemostasis faster and fewer experienced death due to exsanguination at 24hrs Crombie N et al. Ann Emerg Med.

E-9-1-1 145
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Penetrating chest trauma

Don't Forget the Bubbles

All you know, back in ED, is that the ETA is 10 minutes, and there is a single stab wound to the chest. The ODP is caught up leaving theatres and has not yet made it down to ED. The trauma call goes out. You will be running the show today, and you want to use your preparation time well. to −0.5%]; P  = 0.03.). to −0.5%]; P  = 0.03.).

E-9-1-1 139
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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! Linden JV, Bianco C, eds. Transfusion.

Plasma 69
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EM@3AM: Endometritis

EMDocs

A 37-year-old G2P2 female with no other past medical history presents to the ED with a 2-day history of intermittent fever and foul-smelling vaginal discharge. Plasma cell endometritis is associated with Chlamydia trachomatis infection. 2015 Feb 2;2015(2):CD001067. We’ll keep it short, while you keep that EM brain sharp.

EMS 64