ACEP Now

NOVEMBER 16, 2023

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.” 2019:94(4):697-703.

Frozen Plasma 52

Frozen Plasma FFP ALS Plasma 52

REBEL EM

MAY 25, 2023

mental status, urine output, capillary refill) is more important than an actual goal PERMISSIVE HYPOTENSTION IN PTS WITH TBI Brotfain E et al. mental status, urine output, capillary refill) is more important than an actual goal PERMISSIVE HYPOTENSTION IN PTS WITH TBI Brotfain E et al. Richards JE et al. NEJM 1994. [2]

E-9-1-1 145

E-9-1-1 Plasma ALS OR 145

EMDocs

JUNE 14, 2023

Boostani R, Mellat A, Afshari R, et al: Delayed polyneuropathy in farm sprayers due to chronic low dose pesticide exposure. PMID: 23163581] Muñoz-Quezada MT, Lucero BA, Iglesias VP, et al. These are send-out labs with turn-around times that make them unlikely to affect the ED course. References: Tintinalli, J. McGraw-Hill Education.

E-9-1-1 70

E-9-1-1 Emergency Department Plasma ED 70

EMDocs

JUNE 7, 2023

8 Plasma butyrylcholinesterase (“pseudocholinesterase”) activity Easier to assay and is more widely available Red cell acetylcholinesterase (“true cholinesterase”) activity More accurate and specific Management: Patients require immediate intervention if there is concern for acute organophosphate poisoning. Otherwise, provide supportive care.

E-9-1-1 83

E-9-1-1 ICU Emergency Department ED 83

Don't Forget the Bubbles

AUGUST 12, 2024

Hypertonic saline contains a higher sodium concentration than normal plasma and interstitial fluid. Ben Abdeljelil A, Freire GC, Yanchar N, et al. Doi:10.1056/NEJMc2201761 Kochanek PM, Adelson PD, Rosario BL, et al. 2022.0891 Kochanek PM, Tasker RC, Carney N, et al. 2019 Apr;20(4):404]. 2019 Apr;20(4):404].

ALS 75

ALS Emergency Department OR Plasma 75

Don't Forget the Bubbles

MAY 15, 2023

This response varies between individuals, age groups and developmental stages, so a single plasma concentration cannot be defined. If there is clinical concern for hypoglycaemia, plasma glucose concentration should be measured. Learning point: Take a plasma glucose sample and ask the lab to run it urgently – time is sugar!

ED 101

ED Plasma OR ALS 101

Don't Forget the Bubbles

AUGUST 2, 2023

Pro-inflammatory states may also play a role, as patients with CRPS have significantly higher levels of plasma cytokines and chemokines. Cognitive behavioural therapy (CBT) In a study by Brinkers et al. A small, retrospective review by Brooke et al. More recently, Mesaroli et al. 2019 Dec;35(12):933-940.

MPD 98

MPD ALS Plasma OR 98

Don't Forget the Bubbles

JUNE 30, 2023

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. Pragmatic Randomized Optimal Platelet and Plasma Ratios (PROPPR) Trial: design, rationale and implementation. to −0.5%]; P  = 0.03.).

E-9-1-1 139

E-9-1-1 FFP Plasma Emergency Department 139

REBEL EM

JUNE 26, 2023

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.

FFP 145

FFP Frozen Plasma ALS Plasma 145

EMDocs

MARCH 11, 2024

3 Between 1990 and 2019, there were approximately 3 million deaths due to cholera globally, indicating a significant public health issue. References Montero DA, Vidal RM, Velasco J, et al. 2023.1155751 Li X, Wu Y, Sun X, et al. 0054395 Qureshi K, Molbak K, Sandstrom A, et al. link] Roy SK, Hossain MJ, Khatun W, et al.

ED 90

ED OR ALS Plasma 90

REBEL EM

NOVEMBER 28, 2022

Xian 2019) 4-Factor Prothrombin Complex Concentrates (4F-PCC), or K-Centra, is a derivative of human plasma and is explicitly used to reverse vitamin K antagonists such as warfarin and non-specifically in the reversal of DOACs. Ammar 2021, Pham 2022, Parsel 2022) However, Korebey et al. 2019, April 4). JAMA Netw Open.

OR 52

OR ALS Plasma EMS 52

EMDocs

JUNE 3, 2023

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. doi:10.1186/s13017-017-0117-6 Anand T, El-Qawaqzeh K, Nelson A, et al.

ED 54

ED Operating Room ALS Frozen Plasma 54

Don't Forget the Bubbles

JULY 5, 2023

SCD, therefore, is not only a mechanical disease but there are also many other cellular and plasma factors as well as endothelial interaction that generate chronic inflammation. Macharia AW et al. Sinkin JC, Wood BC, Sauerhammer TM, et al. Ware et al. 2019, 3 rd edition. Clinical Epidemiology of SCA in Africa.Am

E-9-1-1 126

E-9-1-1 ACS OR ICU 126