2021, ALS and Plasma - Paramedicine Now

Thrombotic Thrombocytopenic Purpura (TTP)

Core EM

JANUARY 25, 2024

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. Decreases production of anti-ADAMTS13 antibodies by removing the B cells that mature into autoantibody-secreting plasma cells. Paydary, Koosha, et al.

Plasma

Plasma Frozen Plasma Emergency Department FFP

Trauma Resuscitation Updates

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

E-9-1-1 Plasma ALS OR

SGEM#347: It Don’t Matter to Me – Balanced Solution or Saline

The Skeptics' Guide to EM

OCTOBER 3, 2021

Date: September 28th, 2021 Reference: Zampieri et al. Date: September 28th, 2021 Reference: Zampieri et al. Clinical Question: Does administration of a balanced solution (Plasma-Lyte 148) during intensive care unit (ICU) stay, compared with saline solution, result in improved 90-day survival in critically ill patients?

OR

OR Critical Care ICU Plasma

Snake Bites and Children

Pediatric EM Morsels

MARCH 17, 2023

In the US, the venomous snakes include rattlesnakes , copperheads, cottonmouths/water moccasins , and coral snakes [ CDC, 2021 ] Rattlesnakes live all across the United State s Copperheads inhabit the eastern U.S. If you are managing a snake bite from a snake that does not typically reside in the U.S.,

Frozen Plasma

Frozen Plasma Plasma First Aid OR

Penetrating chest trauma

Don't Forget the Bubbles

JUNE 30, 2023

In 2021, Evans and colleagues (1) compared adolescent mortality rates in adult, children’s and mixed major trauma centres across the UK. In 2021, Kulvatunyou, Bauman and colleagues compared the insertion of traditional 28-32Fr chest tubes with 14Fr pigtail catheters for drainage of traumatic haemothorax. Is he going to be OK?

E-9-1-1

E-9-1-1 FFP Plasma Emergency Department

emDOCs Podcast – Episode 102: Hypocalcemia in Trauma and the Diamond of Death

EMDocs

JUNE 12, 2024

Giancarelli et al found that 97% of patients who underwent massive transfusion protocols during trauma resuscitation were hypocalcemic (iCa < 1.1 Kyle et al demonstrated that transfusing a single unit of pRBCs can lead to significant decreases in Ca. 2021 Mar;41:104-109. 2021 Feb 1;90(2):396-402. Am J Emerg Med.

ALS

ALS FFP Plasma Emergency Department

Resident Journal Review: Massive Transfusion Protocols (MTPs) in Traumatic Hemorrhage

AAEM RSA

APRIL 1, 2021

2,3 Here we examine some of the evidence behind the various components of MTPs, specifically calcium and factor VIIa, and the ratios in which the main products of red blood cells, plasma, and platelets should be administered. Holcomb JB, Tilley BC, Baraniuk S, et al. Cornelius B, Ferrell E, Kilgore P, et al. 2020;88(5):383-9.

E-9-1-1

E-9-1-1 Plasma ACS ALS

Best Practices for Upper Gastrointestinal Hemorrhage

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

Frozen Plasma FFP ALS Plasma

Andexxa Vs 4F-PCC in ICH: An Ongoing Debate

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. 2021 Aug;35(1):255-261.

OR

OR Plasma ALS EMS

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

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

ED Operating Room ALS Frozen Plasma

Complex Regional Pain Syndrome

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. Taylor SS, Noor N, Urits I, et al.

MPD

MPD ALS Plasma OR

ToxCard: Crotalid Envenomation Part 2 – CroFab vs. AnaVip: What’s the Difference?

EMDocs

AUGUST 31, 2023

In April 2021, after a post-hoc analysis of the original phase 3 study suggested non-inferiority of the F(ab’) 2 antivenin against copperhead envenomation, the FDA expanded approval of this antivenom to include copperhead and cottonmouth envenomations. Plasma half-life of the F(ab’) 2 antivenom is significantly longer at 5.5

Allergic Reaction

Allergic Reaction Plasma ALS EMS

A guide to major haemorrhage management in paediatrics

Don't Forget the Bubbles

OCTOBER 28, 2024

Karageorgos S, Ren D, Ranaweera M, et al. Major haemorrhage protocols typically include a mixture of packed red blood cells (pRBCs), platelets, and fresh frozen plasma (FFP). Re ferences Al-Jeabory M, Gasecka A, Wieczorek W, Mayer-Szary J, Jaguszewski MJ, Szarpak L. 2021.02.009 George S, Wake E, Jansen M, et al.

Frozen Plasma

Frozen Plasma FFP Plasma ALS

Sepsis Updates Relevant to the Emergency Physician

EMDocs

DECEMBER 18, 2023

The most recent surviving sepsis campaign (SSC) guidelines were released in 2021, which provided 93 recommendations for evidence-based sepsis management. 1 Since 2021, attempts to identify a single screening tool with optimal sensitivity and specificity to predict which patients will develop sepsis or septic shock have been ongoing.

E-9-1-1

E-9-1-1 ALS Emergency Department Plasma

Cholera: ED presentation, evaluation, and management

EMDocs

MARCH 11, 2024

Published online October 20, 2021. Although IgA has limited systemic circulation (~6 months), the memory B cells that are responsible for preventing cholera infection persist and can quickly expand and differentiate into plasmablasts and eventually the plasma cells, which can reseed protective antibodies upon antigen-contact activation.

ED

ED OR ALS Plasma

EM@3AM: Neurosyphilis

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., Rosh Review Website Link References: Tudor ME, Al Aboud AM, Leslie SW, Gossman W. doi:10.1056/NEJMra1906228 Ha T, Tadi P, Leslie SW, et al. In: StatPearls. N Engl J Med.

EMS

EMS E-9-1-1 Plasma ALS

Paramedicine Now

Thrombotic Thrombocytopenic Purpura (TTP)

Trauma Resuscitation Updates

Trending Sources

SGEM#347: It Don’t Matter to Me – Balanced Solution or Saline

Snake Bites and Children

Penetrating chest trauma

emDOCs Podcast – Episode 102: Hypocalcemia in Trauma and the Diamond of Death

Resident Journal Review: Massive Transfusion Protocols (MTPs) in Traumatic Hemorrhage

Best Practices for Upper Gastrointestinal Hemorrhage

Andexxa Vs 4F-PCC in ICH: An Ongoing Debate

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

Complex Regional Pain Syndrome

ToxCard: Crotalid Envenomation Part 2 – CroFab vs. AnaVip: What’s the Difference?

A guide to major haemorrhage management in paediatrics

Sepsis Updates Relevant to the Emergency Physician

Cholera: ED presentation, evaluation, and management

EM@3AM: Neurosyphilis

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