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Thrombotic Thrombocytopenic Purpura (TTP)

Core EM

Deficient ADAMTS-13 activity alone typically does not result in TTP; therefore, it is essential to consider contributing precipitants, including pregnancy, HIV, acute infection, inflammation (SLE, malignancy, pancreatitis) and medication use (ex., Clinical Presentation: Classic pentad (mnemonic FAT RN) is rare and seen in less than 7% of cases.

Plasma 246
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Snake Bites and Children

Pediatric EM Morsels

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. Usually, animals bite from fear or defense of their offspring ( ex, Brown Recluse ).

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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.”

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

EMDocs

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
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A guide to major haemorrhage management in paediatrics

Don't Forget the Bubbles

Major haemorrhage protocols typically include a mixture of packed red blood cells (pRBCs), platelets, and fresh frozen plasma (FFP). This makes comparing data across research trials challenging. As you prepare to administer the next unit, you consider what ratio of blood products to use. What blood product ratio should we use?