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Anticoagulation Reversal

Core EM

Updated 2023 Jun 22]. Treasure Island (FL): StatPearls Publishing; 2023 Jan-. Background Around 6 million people in the U.S. 2017 ACC Expert Consensus Decision Pathway on Management of Bleeding in Patients on Oral Anticoagulants: A Report of the American College of Cardiology Task Force on Expert Consensus Decision Pathways.

FFP 130
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CRYOSTAT-2: Early Empiric Cryoprecipitate in Major Trauma

REBEL EM

Most major hemorrhage protocols give a balanced transfusion of PRBCs, FFP, and platelets in ratios approaching concentrations found in whole blood. Fibrinogen and fibrin are often depleted during major trauma as a result of consumption, breakdown, and dilution. Fibrinogen products may also be needed to stabilize clots and stem bleeding.

FFP 128
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EM@3AM: Amniotic Fluid Embolism

EMDocs

A 37-year-old G5P4 at 33 weeks presents to the ED after being brought in by ambulance. 2023 Dec 13;52(2):126-135. doi: 10.1515/jpm-2023-0365. We’ll keep it short, while you keep that EM brain sharp. She had a precipitous delivery while the ambulance was pulling in. J Matern Fetal Neonatal Med. 2015 May;28(7):793-8.

EMS 95
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Penetrating chest trauma

Don't Forget the Bubbles

All you know, back in ED, is that the ETA is 10 minutes, and there is a single stab wound to the chest. The ODP is caught up leaving theatres and has not yet made it down to ED. a) A balanced ratio of 1:1:1 (platelets: FFP: packed red cells) The PROPPR trial showed us that balanced ratios are important. The trauma call goes out.

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

ACEP Now

2 TTP often presents abruptly, and most patients that develop it first visit the emergency department (ED) as their symptoms worsen. 1 Pregnant patients are particularly vulnerable to misdiagnosis of TTP in the ED. Updated April 7, 2023. Most of these deaths can be attributed to a delay in diagnosis. In:StatPearls [Internet].