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Thrombotic Thrombocytopenic Purpura (TTP)

Core EM

source: “Thrombotic Thrombocytopenic Purpura (TTP)”, 2022 , National Heart, Lung, and Blood Institute. 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.

Plasma 246
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SGEM386: Blood on Blood – Massive Transfusion Protocols in Older Trauma Patients

The Skeptics' Guide to EM

Date: December 16th, 2022 Reference: Hohle et al. AEM December 2022 Guest Skeptic: Dr. Kirsty Challen is a Consultant in Emergency Medicine at Lancashire Teaching Hospitals. Date: December 16th, 2022 Reference: Hohle et al. Massive Blood Transfusion Following Older Adult Trauma: the Effect of Blood Ratios on Mortality.

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Data Café Insights: Whole Blood and PRBC Usage

ESO

Pulling data from the world’s largest de-identified medical database, the Index’s insights reflect over 968,538 hospital records from 596 hospital systems that took place between January 1 st and December 31 st of 2022. Balance resuscitation strategy, often in a 1:1:1 ratio of PRBCs with fresh frozen plasma and platelets.

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Penetrating chest trauma

Don't Forget the Bubbles

a) A balanced ratio of 1:1:1 (platelets: FFP: packed red cells) The PROPPR trial showed us that balanced ratios are important. 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.

E-9-1-1 139
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Recognition and Treatment of Thrombotic Thrombocytopenic Purpura

ACEP Now

Therapeutic plasma exchange (TPE) with fresh frozen plasma (FFP) is the first-line treatment, by simultaneously supplying fresh ADAMTS13 and removing anti-ADAMTS13 autoantibodies. Therapeutical plasma exchange for thrombotic thrombocytopenic purpura in the emergency department: A single center experience. 2021;10(3):536.

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Guideline Update: Acute Lower GI Bleeding

EMDocs

For patients on VKAs to prevent stroke in nonvalvular atrial fibrillation who require reversal, 4-factor prothrombin complex concentrate (PCC) is preferred to fresh frozen plasma (FFP) because of the rapidity of INR reduction (Conditional recommendation, very low-quality evidence). Epub 2022 Sep 21. Am J Gastroenterol.

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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). Platelets and FFP replace lost platelets and coagulation factors, which help with clotting and also provide some volume expansion. Published 2022 May 4. 2022 Apr 22;8(1):25.