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Data Café Insights: Whole Blood and PRBC Usage

ESO

The 2023 ESO Trauma Index offers a detailed analysis of current trends and benchmarks in trauma care, setting a new standard for improvement and allowing healthcare professionals to get a closer look at the data, understand its impact, and explore best practices for enhancing patient outcomes.

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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.

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Snake Bites and Children

Pediatric EM Morsels

Accessed March 13, 2023. Accessed March 17, 2023. (Judge 2019) Best when given within 4 hours of the bite, but still effective within 24 hours Always give an entire vial of antivenom, never a partial vial. It’s expensive, so if you’re giving some of a vial, give it all. J Emerg Trauma Shock. 2008;1(2):97-105. Published June 28, 2021.

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REBEL Cast Ep 118: The PROCOAG Trial – 4F-PCC for Trauma Patients?

REBEL EM

Reversal of Trauma-Induced Coagulopathy Using First-Line Coagulation Factor Concentrates or Fresh Frozen Plasma (RETIC): A Single-Centre Parallel-Group, Open-Label Randomised Trial. PMID: 36942533 Innerhofer P et al. Lancet Haematol 2017. PMID: 28457980 Jehan F et al.

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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). 2023 Feb 1;118(2):208-231. Am J Gastroenterol.

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

EMDocs

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. Accessed on April 15, 2023. Accessed April 15, 2023. Accessed April 29, 2023. Published April 17, 2023. Accessed April 29, 2023.

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