Pediatric EM Morsels

MARCH 17, 2023

Since we all inhabit the same beautiful world , and sometimes we humans overtake previous habitats of animals, we inevitably will cross paths with an animal that bites us. Usually, animals bite from fear or defense of their offspring ( ex, Brown Recluse ). Sometimes it’s a beloved pet who gets surprised or has an “off” day ( Dog Bites and PTSD ).

Frozen Plasma 130

Frozen Plasma Plasma First Aid OR 130

The Skeptics' Guide to EM

APRIL 6, 2019

Date: April 5th, 2019 Reference: Connolly et al. NEJM 2019 Guest Skeptic: Dr. Ryan Radecki is an Emergency Physician at Kaiser Permanente NW, co-host of the Annals of Emergency Medicine podcast and Journal Club section editor. Date: April 5th, 2019 Reference: Connolly et al.

Frozen Plasma 130

Frozen Plasma Plasma ALS EMS 130

EMDocs

APRIL 10, 2024

Metabolism of ester anesthetics is by plasma cholinesterase, whereas amides are metabolized by the cytochrome P450 system in the liver. [6] 6] Action of local anesthetics is dependent upon the molecule crossing the plasma membrane in a unionized form. [2] 2] This linking group can be either an amide (e.g., lidocaine) or an ester (e.g.,

E-9-1-1 93

E-9-1-1 Plasma Epinephrine Life Support 93

The Overrun

JUNE 3, 2023

Through the years, we see a change to plasma, then crystalloid, and then 1:1:1 therapy. Once compared, while 1:1:1 therapy or giving PRBCs or plasma alone is better than crystalloid, whole blood is preferable and may have more of a survival benefit for patients. In the First World War, the preferred resuscitation fluid was whole blood.

Plasma 52

Plasma Paramedicine Paramedicine EMS 52

Core EM

OCTOBER 2, 2024

Author: Natalie Bertrand, MD Editor: Naillid Felipe, MD Background: Definition: adverse reaction to blood product administration Incidence: more common in children than adults, except for delayed hemolytic transfusion reactions Allergic (non-anaphylaxis) – Platelets 1-3%; RBCs 0.1-0.3% mg IF requiring IM Epi >3x, switch to IV Epi, 0.05-0.1

Allergic Reaction 100

Allergic Reaction Plasma ED Epinephrine 100

EMDocs

JULY 11, 2023

Today on the emDOCs cast, Brit Long, MD ( @long_brit) covers hemophilia, including background, severity, evaluation, and management. Episode 81: Hemophilia What is hemophilia? Bleeding disorder due to a deficiency in one or more of the proteins (factors) involved in the coagulation pathway. Most common site is hemarthrosis (70-80% of cases).

Plasma 62

Plasma ALS OR Emergency Department 62

EMDocs

MAY 23, 2024

3 Measured in analytical testing : Laboratories measure plasma concentration using osmometers which measures values as a function of kilograms of solvent. New York Mcgraw-Hill Education; 2019. Choice of the best equation for plasma osmolality calculation: Comparison of fourteen formulae. Goldfrank’s Toxicologic Emergencies.

Plasma 65

Plasma EMS ED OR 65

Don't Forget the Bubbles

JUNE 30, 2023

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.

E-9-1-1 139

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

REBEL EM

JUNE 26, 2023

Severe acute traumatic coagulopathy = PT >1.5 to 3.33; P = 0.72 NOT STATISTICALLY SIGNIFICANT Also no difference in individual components given Thromboembolic Events: 4F-PCC: 35% Placebo: 24% Absolute Diff: 11%; 95% CI 1 to 21% Relative Risk 1.48; 95% CI 1.04 to 2.10; P = 0.03 Severe acute traumatic coagulopathy = PT >1.5 to 3.33; P = 0.72

FFP 145

FFP Frozen Plasma ALS Plasma 145

Don't Forget the Bubbles

AUGUST 12, 2024

This can be from the brain hitting the skull, shear forces from sudden acceleration and deceleration, or direct injury at the point of impact. The severity of head injuries can be classified according to the GCS. TBI occurs in two stages: a primary brain injury and a secondary brain injury. This insult to the brain is often irreversible.

ALS 75

ALS Emergency Department OR Plasma 75

EMDocs

SEPTEMBER 7, 2023

DEG is rapidly absorbed when ingested and can reach peak plasma and brain tissue concentrations within four hours of ingestion. Upon review of the history, several of the patients had been exposed to a liquid acetaminophen-based teething medication. 1 Clinical Questions: When should a clinician suspect diethylene glycol (DEG) toxicity?

E-9-1-1 65

E-9-1-1 ALS Emergency Department Plasma 65

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.” 6 Balloon tamponade (i.e.,

Frozen Plasma 52

Frozen Plasma FFP ALS Plasma 52

EMDocs

JULY 19, 2023

However, in extreme cases with highly toxic levels, one could consider plasma exchange if no other suitable alternative exists. She first noticed herself bumping into walls but attributed it to being absent-minded or not paying enough attention to where she was going.

ACS 66

ACS Plasma OR ED 66

EMDocs

JUNE 14, 2023

He has a glove and stocking pattern of numbness to his extremities. Motor and sensory findings are symmetrical. Patellar reflexes are 1+. He has no saddle anesthesia or back pain and denies any difficulty urinating or issues with defecation. Paraquat Influenza vaccine Methanol Organophosphate Are his symptoms reversible?

E-9-1-1 70

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

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. The question remains—Which reversal agent is ideal in anticoagulant-associated intracranial bleeding (ICB)?

OR 52

OR Plasma ALS EMS 52

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. 7 May lead to respiratory failure.

E-9-1-1 83

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

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. In addition, free haem and haemoglobin contribute to the vascular damage. Blood film shows sickle cells and a further sample was sent for confirmation of diagnosis.

E-9-1-1 126

E-9-1-1 ACS OR ICU 126

EMDocs

JUNE 3, 2023

Introduction The pelvic ring is made up of the bony ilium, ischium, pubis, and sacrum, which are held together with ligaments. Pelvic fractures can involve disruptions in any of the bony or ligamentous structures of the pelvic ring. Due to the round shape of the pelvic ring, multiple fractures typically occur concurrently.

ED 54

ED Operating Room ALS Frozen Plasma 54

EMDocs

NOVEMBER 2, 2024

The development of an inflammatory process is largely due to the infiltration of lymphocytes and plasma cells which ultimately result in nerve damage (e.g., Per the patient’s partner, he has not experienced any fevers, chills, cough, congestion, or recent illness and was not complaining of headaches or vision changes.

EMS 92

EMS E-9-1-1 Plasma ALS 92

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 103

ED Plasma OR ALS 103

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. What is Complex Regional Pain Syndrome? CRPS is distinguished from other chronic pain conditions by the presence of signs indicating prominent autonomic and inflammatory changes in the region of pain.

MPD 98

MPD ALS Plasma OR 98

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. 3 Between 1990 and 2019, there were approximately 3 million deaths due to cholera globally, indicating a significant public health issue. The extremities were cold with no peripheral edema.

ED 89

ED OR ALS Plasma 89

Pediatric EM Morsels

SEPTEMBER 6, 2024

We talk about a lot of common, not-to-miss diagnoses here at the Morsel Bakery, but we also talk about remaining vigilant for more subtle or uncommon diagnoses. We have spoken about causes to consider when working up a Fever of Unknown Origin including Myocarditis , Osteomyelitis , Acute Rheumatic Fever , and Lemierres syndrome.

Plasma 152

Plasma OR EMS 152