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Thrombotic Thrombocytopenic Purpura (TTP)

Core EM

Annual incidence of approximately 2-4 cases/million/year (Kappler, 2017), with 90% of cases occurring in adulthood. Joly, 2017) Risk factors include: Female, 2:1 female to male predominance (Terrell, 2010) Black race Obesity TTP is a life-threatening condition with mortality of 10-20% despite targeted therapies.

Plasma 246
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Anticoagulation Reversal

Core EM

2017 ACC Expert Consensus Decision Pathway on Management of Bleeding in Patients on Oral Anticoagulants: A Report of the American College of Cardiology Task Force on Expert Consensus Decision Pathways. Anticoagulant Reversal Strategies in the Emergency Department Setting: Recommendations of a Multidisciplinary Expert Panel.

FFP 130
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REBEL Core Cast 108.0 – Angioedema

REBEL EM

patients that take ACE inhibitors (but 20-30% of all angioedema presentations to the Emergency Department) 3 times more common in Black Americans ( Kostis 2005 ) 0.01 J Allergy Clin Immune Tract 2017; 5(5): 1402-9. Angioedema in the Emergency Department: An Evidence Based Review. Emergency Medicine Practice.

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

The Skeptics' Guide to EM

Kirsty Challen is a Consultant in Emergency Medicine at Lancashire Teaching Hospitals. Case: A 71-year-old man is brought to your emergency department (ED) by emergency medical serviced (EMS) having fallen two steps at home. years ( 2 ).

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

EMDocs

FFP and platelets also contain citrate. Ionised calcium levels in major trauma patients who received blood in the Emergency Department. Emerg Med J. Blood products, including both packed red blood cells and whole blood, are stored with the anticoagulant citrate, with can bind Ca and lower ionized Ca levels. J Surg Res.

ALS 89
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Penetrating chest trauma

Don't Forget the Bubbles

a) A balanced ratio of 1:1:1 (platelets: FFP: packed red cells) The PROPPR trial showed us that balanced ratios are important. b) A balanced ratio of 1: 1:2 (platelets: FFP: packed red cells) The PROPPR trial showed us that balanced ratios are important. b) Emergency thoracotomy Let’s be clear: YOU will not be doing any of this.

E-9-1-1 139
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Best Practices for Upper Gastrointestinal Hemorrhage

ACEP Now

Fresh frozen plasma, or FFP, should only be given to cirrhotic patients as part of the massive transfusion protocol in cases of profound hypotension, as “patients with cirrhosis rarely have true enzymatic hypocoagulability, and FFP may worsen bleeding due to over-resuscitation and dilution of coagulation factors.” Acad Emerg Med.