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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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Emergency Department Evaluation of Cholestatic Labs

EMDocs

Darnall Army Medical Center) // Reviewed by: Joshua Lowe, MD (EM Attending Physician, USAF); Marina Boushra (EM-CCM, Cleveland Clinic Foundation); Brit Long, (@long_brit) Disclaimer: The views expressed in this post are those of the authors and do not reflect the official policy or position of the Department of the Army, DoD, or the US Government.

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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 Without the C1 inhibitor, the plasma-kallikrein-kinin system produces more bradykinin. J Emerg Med 2013; 44 (4): 764-772. N Engl J Med. 2015; 372(5):418-25.

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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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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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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. Interim results presented earlier this year show that REBOA performed within the Emergency Department increased mortality.

E-9-1-1 139
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emDOCs Podcast – Episode 102: Hypocalcemia in Trauma and the Diamond of Death

EMDocs

Two randomized controlled trials by Moore et al found that prehospital plasma administration in trauma patients is associated with hypoCa (53% vs 36%). Ionised calcium levels in major trauma patients who received blood in the Emergency Department. Emerg Med J. How does this impact the prehospital environment? J Surg Res.

ALS 89