Remove 2018 Remove OR Remove Plasma
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Thrombotic Thrombocytopenic Purpura (TTP)

Core EM

Renal injury: isolated proteinuria or hematuria, moderate acute kidney injury with serum creatinine levels <2 mg/dL Skin: petechiae and purpura Despite severe thrombocytopenia, clinically significant bleeding is rare Figure 1.

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SGEM#369: Romeo is Bleeding – Does He Need a RePHILL?

The Skeptics' Guide to EM

The paramedic asks you, “we have saline, and we also have red-cells and this fancy new lyophilised plasma. Should we give our shocked patient saline or plasma / red cells en route to the ED?” The Control of Major Bleeding After Trauma ( COMBAT ) Trial was published in the Lancet in 2018. What do you advise him?

Plasma 100
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Acute Transverse Myelitis in Children

Pediatric EM Morsels

Tavasoli 2018, Wolf 2012) More common in adults; children comprise 20% of total cases (Pidcock 2007, Wang 2019) Bimodal age distribution (Absoud 2016) Children < 5 years Children > 10 years Symptoms evolve over 2-4 days and peak at 5-6 days (Absoud 2016) ATM may occur alone OR as part of another disorders (e.g. 28,1 (2008): 105-20.

Plasma 141
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ACMT Toxicology Visual Pearls: On the Mark

ALiEM

Note that succinylcholine is contraindicated as it is metabolized by plasma pseudocholinesterase. 2018 Jan 5;359(6371):23. This kit has historically been issued to US service members for treating nerve agent toxicity from agents such as soman, sarin, tabun, and VX, all of which are organophosphates and cause a cholinergic toxidrome.

Plasma 195
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Congenital Syphilis

Pediatric EM Morsels

Foles, 2024 ] In the US, from 2013-2018, cases increased from 362 to 1,306. Neonates presenting to the Emergency Department often cause a lot of uncertainty. Is this scalp swelling normal? Is this bloody stool concerning? Are this odd movements part of normal development? Is that umbilical area ok or concerning? May be on soles of feet !

E-9-1-1 152
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SGEM#251: Nothing Compares to You…Because there was No Comparison Group

The Skeptics' Guide to EM

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 ). The FDA granted accelerated approval for andexanet alfa (Andexxa) in May of 2018. Dabigatran is a direct thrombin inhibitor.

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Penetrating chest trauma

Don't Forget the Bubbles

You ask your anaesthetist to get ready to sedate or intubate depending on their status – Significant risk to the department – you make sure security is aware And your patient arrives. Ranulf is quite a sweet, round-faced boy, accompanied by his traumatised-looking mother as he is wheeled to your trauma bay.

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