2015 and Plasma - Paramedicine Now

Podcast 185.0: Anticoagulation Reversal

Core EM

JANUARY 25, 2024

2015 Dec 22;132(25):2412-22. Comparison between Prothrombin Complex Concentrate (PCC) and Fresh Frozen Plasma (FFP) for the Urgent Reversal of Warfarin in Patients with Mechanical Heart Valves in a Tertiary Care Cardiac Center. 2015 Dec 17;373(25):2413-24. Epub 2015 Nov 11. Ann Emerg Med. 2020;76(4):470-485. Circulation.

Frozen Plasma

Frozen Plasma FFP Plasma Critical Care

SGEM#251: Nothing Compares to You…Because there was No Comparison Group

The Skeptics' Guide to EM

APRIL 6, 2019

In contrast, protamine could be used for heparin and LMWH reversal and vitamin K, fresh frozen plasma and prothrombinase complex concentrate could be used to reverse coumadin ( Hunt and Levi BMJ 2018 ). This changed in 2015 when the Food and Drug Administration (FDA) approved idarucizumab for the reversal of dabigatran.

Frozen Plasma

Frozen Plasma Plasma ALS EMS

Whole Blood: Ready for Prime Time

The Overrun

JUNE 3, 2023

Through the years, we see a change to plasma, then crystalloid, and then 1:1:1 therapy. Once compared, while 1:1:1 therapy or giving PRBCs or plasma alone is better than crystalloid, whole blood is preferable and may have more of a survival benefit for patients. In the First World War, the preferred resuscitation fluid was whole blood.

Plasma

Plasma Paramedicine Paramedicine EMS

Maintenance Fluids in Critical Illness

Don't Forget the Bubbles

NOVEMBER 15, 2023

Have a look to see how their osmolarity and tonicity across the cell membrane compare to plasma. Renal (= urine output) : anti-diuretic hormone (ADH) release from the posterior pituitary is stimulated by microchanges in plasma osmolarity. What loss mechanisms do we need to consider? A fluid shift, if you will. Lancet (London, England).

Plasma

Plasma ALS ICU Critical Care

REBEL Core Cast 108.0 – Angioedema

REBEL EM

SEPTEMBER 13, 2023

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.

Frozen Plasma

Frozen Plasma Allergic Reaction FFP Plasma

Trauma Resuscitation Updates

REBEL EM

MAY 25, 2023

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

E-9-1-1 Plasma ALS OR

Penetrating chest trauma

Don't Forget the Bubbles

JUNE 30, 2023

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. Pragmatic Randomized Optimal Platelet and Plasma Ratios (PROPPR) Trial: design, rationale and implementation. 2015 Jul;115(1):76-83.

E-9-1-1

E-9-1-1 FFP Plasma Emergency Department

Postpartum Hemorrhage: The Chapter We Skipped.

FOAMfrat

AUGUST 15, 2024

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! Like I said, some blood is better than no blood!

Plasma

Plasma Ambulance ALS Emergency Department

Complex Regional Pain Syndrome

Don't Forget the Bubbles

AUGUST 2, 2023

Pro-inflammatory states may also play a role, as patients with CRPS have significantly higher levels of plasma cytokines and chemokines. Orthop Traumatol Surg Res 2015; 101: pp. Published 2015 Jul 29. We know that fractures are the precipitating event in about 5–14% of cases and surgical procedures in 10–15%. Audouin-Pajot C.,

MPD

MPD ALS Plasma OR

EM@3AM: Endometritis

EMDocs

JULY 13, 2024

Plasma cell endometritis is associated with Chlamydia trachomatis infection. 2015 Feb 2;2015(2):CD001067. Chorioamnionitis and endometritis. Infect Dis Clin North Am. 1997 Mar;11(1):203-22. doi: 10.1016/s0891-5520(05)70349-4. PMID: 9067792. Paukku M, Puolakkainen M, Paavonen T, Paavonen J. Am J Clin Pathol. 1999 Aug;112(2):211-5.

EMS

EMS E-9-1-1 Plasma OR

ToxCard: Crotalid Envenomation Part 2 – CroFab vs. AnaVip: What’s the Difference?

EMDocs

AUGUST 31, 2023

However, in 2015 crotalidae equine immune F(ab’) 2 (ANAVIP®) was approved by the FDA for rattlesnake envenomations, and distribution of this antivenom began in 2018. Plasma half-life of the F(ab’) 2 antivenom is significantly longer at 5.5 5 Figure 1. Table 1: Comparison of F(ab) and F(ab’) 2 antivenoms.

Allergic Reaction

Allergic Reaction Plasma ALS EMS

emDOCs Podcast – Episode 102: Hypocalcemia in Trauma and the Diamond of Death

EMDocs

JUNE 12, 2024

Two randomized controlled trials by Moore et al found that prehospital plasma administration in trauma patients is associated with hypoCa (53% vs 36%). How does this impact the prehospital environment? Prehospital blood product transfusion increases risk of hypoCa. Anaesth Intensive Care. 2011;39(1):46-54. Li K, Xu Y. Int J Clin Exp Med.

ALS

ALS FFP Plasma Emergency Department

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

The Skeptics' Guide to EM

DECEMBER 17, 2022

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)? Noting with some relief that at least he isn’t anticoagulated, you activate the hospital massive transfusion protocol. years ( 2 ).

Frozen Plasma

Frozen Plasma FFP Emergency Medical Services Plasma

ToxCard: Organic Mercury Poisoning

EMDocs

JULY 19, 2023

However, in extreme cases with highly toxic levels, one could consider plasma exchange if no other suitable alternative exists. 2015, March 26). Chelation is generally indicated in cases where patients are experiencing symptoms of toxicity (even the vague, non-specific ones) or there are elevated concentrations of mercury in blood.

ACS

ACS Plasma OR ED

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

EMDocs

JUNE 3, 2023

Institutional protocols should be utilized, keeping in mind that either whole blood or a 1:1:1 ratio of packed red blood cells, platelets, and fresh frozen plasma are optimal. link] Published June 23, 2015. Young and Burgess classification of pelvic ring fractures. Radiopaedia.org. Published November 8, 2022. Radiopaedia.org.

ED

ED Operating Room ALS Frozen Plasma

Sickle Cell Disease Module

Don't Forget the Bubbles

JULY 5, 2023

SCD, therefore, is not only a mechanical disease but there are also many other cellular and plasma factors as well as endothelial interaction that generate chronic inflammation. Anemia ; 2015.DOI:10.1155/2015/791498. DOI:10.1155/2015/791498. Plast Reconstr Surg – Glob Open 2015; 3: 83–86. References Adewoyin AS.

E-9-1-1

E-9-1-1 ACS OR ICU

Paramedicine Now

Podcast 185.0: Anticoagulation Reversal

SGEM#251: Nothing Compares to You…Because there was No Comparison Group

Trending Sources

Whole Blood: Ready for Prime Time

Maintenance Fluids in Critical Illness

REBEL Core Cast 108.0 – Angioedema

Trauma Resuscitation Updates

Penetrating chest trauma

Postpartum Hemorrhage: The Chapter We Skipped.

Complex Regional Pain Syndrome

EM@3AM: Endometritis

ToxCard: Crotalid Envenomation Part 2 – CroFab vs. AnaVip: What’s the Difference?

emDOCs Podcast – Episode 102: Hypocalcemia in Trauma and the Diamond of Death

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

ToxCard: Organic Mercury Poisoning

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

Sickle Cell Disease Module

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