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Thrombotic Thrombocytopenic Purpura (TTP)

Core EM

Joly, 2017; Sawler, 2020) Fresh frozen plasma (FFP) (contains ADMTS-13) may be used to supplement ADAMTS-13 if there is a delay in initiating TPE in the emergency department (i.e. if the patient is being transferred to another hospital). (Scully, 2012) Citations: Balduini CL, et al. 2018 Nov 30;2018(1):530-538.

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

The Skeptics' Guide to EM

Date: April 5th, 2019 Reference: Connolly et al. Date: April 5th, 2019 Reference: Connolly et al. 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 ).

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REBEL Cast Ep 118: The PROCOAG Trial – 4F-PCC for Trauma Patients?

REBEL EM

Click here for Direct Download of the Podcast Paper: Bouzat P et al. References: Bouzat P et al. PMID: 36942533 Innerhofer P et al. Reversal of Trauma-Induced Coagulopathy Using First-Line Coagulation Factor Concentrates or Fresh Frozen Plasma (RETIC): A Single-Centre Parallel-Group, Open-Label Randomised Trial.

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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.” 2018:36(4):689-698.

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

EMDocs

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. Glick Y, Knipe H, Hacking C, et al. Coccolini F, Stahel PF, Montori G, et al. 2020.01.042 CRASH-2 trial collaborators, Shakur H, Roberts I, et al.

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