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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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SGEM#368: Just A Normal Saline Day in the ICU – The PLUS Study

The Skeptics' Guide to EM

Date: June 12th, 2022 Reference: Finfer et al. Date: June 12th, 2022 Reference: Finfer et al. sodium chloride), and balanced crystalloid solutions, meaning those with a chloride composition closer to plasma such as lactated ringer’s or Plasma Lyte 148. Early work suggested potential harm from 0.9%

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professionals

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Congenital Syphilis

Pediatric EM Morsels

Early Congenital Syphilis Present before 2 years of age [ Hussain, 2023 ; Foles, 2024; Fang, 2022; Morrisroe, 2021 ] Only ~33% of newborns present with symptoms at birth and can be subtle. Congenital Syphilis Epidemiology, Prevention, and Management in the United States: A 2022 Update. 2022 Dec 27;14(12):e33009. Can identify T.

E-9-1-1 152
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Rebaked: Inborn Errors of Metabolism presenting in the ED

Pediatric EM Morsels

Pediatr Rev (2022) 43 (7): 371–383. Your genetics and inpatient colleagues will thank you! Incidence of inborn errors of metabolism in British Columbia, 1969–1996. Pediatrics. 2000; 105:e 10. Inborn Errors of Metabolism: Becoming Ready for Rare. Samantha A. Schrier Vergano.

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SAEM Clinical Images Series: A Case of Painful Skin Lesions

ALiEM

Necrobiosis Lipoidica – This patient had a previous skin biopsy with histopathologic changes demonstrating a granulomatous dermatitis involving the dermis and subcutaneous tissues with necrobiosis of collagen and inflammatory infiltrates of lymphocytes and plasma cells consistent with a diagnosis of necrobiosis lipoidica.

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Anti-NMDA Receptor Encephalitis in Children and Adolescents

Pediatric EM Morsels

First line therapies for anti-NMBDA receptor encephalitis consists of… High dose steroids , IVIG, and PLEX – Therapeutic plasma exchange Only 50% of patient’s respond, and will require second line therapies such as Rituximab. 2022 Jul 6;9(5):e200013. IV acyclovir for HSV coverage while awaiting PCR results. doi: 10.1212/NXI.0000000000200013.

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Episode 97: 2023 Resuscitation Update

The Overrun Podcast

The gang gets back together and discusses new resuscitation data from 2022. Enrolled 789 patients RePHILL Study Question and Methods: Multicenter RCT out of the UK that investigated prehospital resuscitation using PRBCs and plasma versus normal saline to improve tissue perfusion or mortality in adult trauma patients with hemorrhagic shock.

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