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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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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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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 Fresh frozen plasma for progressive and refractory angiotensin-converting enzyme inhibitor-induced angioedema. J Emerg Med 2013; 44 (4): 764-772.

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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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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.

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

EMDocs

For a broader overview of pelvic trauma, please review Dr. Lupez’s 2017 article here: [link]. 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. World J Emerg Surg. Published 2017 Jan 18.

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