ALiEM

OCTOBER 4, 2023

Note that succinylcholine is contraindicated as it is metabolized by plasma pseudocholinesterase. 2023 Mar;97(3):651-661. This kit has historically been issued to US service members for treating nerve agent toxicity from agents such as soman, sarin, tabun, and VX, all of which are organophosphates and cause a cholinergic toxidrome.

Plasma 195

Plasma OR ED 195

Pediatric EM Morsels

MARCH 17, 2023

Since we all inhabit the same beautiful world , and sometimes we humans overtake previous habitats of animals, we inevitably will cross paths with an animal that bites us. Usually, animals bite from fear or defense of their offspring ( ex, Brown Recluse ). Sometimes it’s a beloved pet who gets surprised or has an “off” day ( Dog Bites and PTSD ).

Frozen Plasma 130

Frozen Plasma Plasma First Aid OR 130

REBEL EM

MAY 25, 2023

JAMA 2015 [7] The PROPPR Trial 680 severely injured adult trauma patients Patients randomized to Plasma, Platelets, and PRBCs in a 1:1:1 ratio vs 1:1:2 ratio No difference in overall mortality at 24 hrs BUT 1:1:1 achieved hemostasis faster and fewer experienced death due to exsanguination at 24hrs Crombie N et al.

E-9-1-1 145

E-9-1-1 Plasma ALS OR 145

Don't Forget the Bubbles

JUNE 30, 2023

You ask your anaesthetist to get ready to sedate or intubate depending on their status – Significant risk to the department – you make sure security is aware And your patient arrives. Ranulf is quite a sweet, round-faced boy, accompanied by his traumatised-looking mother as he is wheeled to your trauma bay.

E-9-1-1 139

E-9-1-1 FFP Plasma Emergency Department 139

REBEL EM

JUNE 26, 2023

Efficacy and Safety of Early Administration of 4-Factor Prothrombin Complex Concentrate in Patients with Trauma at Risk of Massive Transfusion: The PROCOAG Randomized Clinical Trial. Severe acute traumatic coagulopathy = PT >1.5 to 3.33; P = 0.72 to 2.10; P = 0.03 Severe acute traumatic coagulopathy = PT >1.5 to 3.33; P = 0.72

FFP 145

FFP Frozen Plasma ALS Plasma 145

ACEP Now

APRIL 5, 2024

Therapeutic plasma exchange (TPE) with fresh frozen plasma (FFP) is the first-line treatment, by simultaneously supplying fresh ADAMTS13 and removing anti-ADAMTS13 autoantibodies. 3 In TTP, patients undergo microangiopathic hemolytic anemia that leads to severe thrombocytopenia and, in severe cases, organ dysfunction.

Frozen Plasma 40

Frozen Plasma Plasma Emergency Department FFP 40

The Curious Clinicians

JANUARY 16, 2024

One well-known study bled volunteers to a hemoglobin of 5 g/dL, while keeping them isovolemic with albumin or plasma infusions. There is one value, however, which we not only leave alone until it is well below normal, but only replenish to barely half the normal value: Hemoglobin (Hgb). Let’s focus on that last point.

Plasma 52

Plasma ACS Critical Care OR 52

ACEP Now

FEBRUARY 6, 2024

For readers who missed the October 2023 Toxicology Q&A , I presented a real case of an occult significant ethylene glycol ingestion illustrated with photographs of brightly glowing urine when exposed to a Wood’s lamp. Artifactual elevation of measured plasma L-lactate concentration in the presence of glycolate. Epub 2023 Sep 11.

ALS 52

ALS Plasma Critical Care OR 52

EMDocs

NOVEMBER 20, 2023

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). Conditional recommendation, low-quality evidence).

Frozen Plasma 79

Frozen Plasma FFP Plasma OR 79

Don't Forget the Bubbles

NOVEMBER 15, 2023

Have a look to see how their osmolarity and tonicity across the cell membrane compare to plasma. Renal (= urine output) : anti-diuretic hormone (ADH) release from the posterior pituitary is stimulated by microchanges in plasma osmolarity. Available at: [link] (Accessed: April 3, 2023). everywhere outside the cells). Pediatrics.

Plasma 80

Plasma ALS ICU Critical Care 80

Don't Forget the Bubbles

AUGUST 12, 2024

This can be from the brain hitting the skull, shear forces from sudden acceleration and deceleration, or direct injury at the point of impact. The severity of head injuries can be classified according to the GCS. TBI occurs in two stages: a primary brain injury and a secondary brain injury. This insult to the brain is often irreversible.

ALS 75

ALS Emergency Department Plasma OR 75

ACEP Now

FEBRUARY 11, 2024

Given the fact that he has not had these headaches before and has diffuse symptoms including weakness, lab work and head imaging are obtained. There were no acute findings on head CT. His lab values demonstrate no anemia, leukocytosis, or electrolyte abnormalities except for an elevated creatinine.

Overdose 52

Overdose ACS Plasma ALS 52

EMDocs

SEPTEMBER 7, 2023

DEG is rapidly absorbed when ingested and can reach peak plasma and brain tissue concentrations within four hours of ingestion. Upon review of the history, several of the patients had been exposed to a liquid acetaminophen-based teething medication. 1 Clinical Questions: When should a clinician suspect diethylene glycol (DEG) toxicity?

E-9-1-1 65

E-9-1-1 ALS Emergency Department Plasma 65

EMDocs

JUNE 3, 2023

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

ED Operating Room ALS Frozen Plasma 54

EMDocs

MARCH 4, 2024

1 GGT is an enzyme located on the plasma membrane of hepatocytes that is involved in the regeneration of glutathione. Case: A 45-year-old woman presents to the emergency department (ED) with itching to bilateral palms. Her medical history is significant for hypertension, hyperlipidemia, and hypothyroidism.

Emergency Department 86

Emergency Department E-9-1-1 ALS OR 86

Dr. Smith's ECG Blog

JULY 27, 2023

Whether the ST Depression on the ECG represents ischemia or not is uncertain, but it does not represent acute coronary syndrome. == MY Comment , by K EN G RAUER, MD ( 7/27 /2023 ): == The most interesting aspects of today’s case are: i ) The tale told by the 6 ECGs; and , ii ) The surprise finding of positive troponins!

Coronary 52

Coronary ACS Naloxone Plasma 52

EMDocs

NOVEMBER 2, 2024

The development of an inflammatory process is largely due to the infiltration of lymphocytes and plasma cells which ultimately result in nerve damage (e.g., Per the patient’s partner, he has not experienced any fevers, chills, cough, congestion, or recent illness and was not complaining of headaches or vision changes.

EMS 91

EMS E-9-1-1 Plasma ALS 91

FOAMfrat

SEPTEMBER 19, 2024

Background and Epidemiology In the United States, roughly 9,000 snake bites are reported annually, with approximately 3,000 being attributed to venomous species and less than 10 resulting in death. Many bites are associated with (human) consumption of alcohol. Fortunately, overall prognosis for snake envenomation within the U.S. Neither will the ER.

Emergency Department 90

Emergency Department Epinephrine OR Plasma 90

Don't Forget the Bubbles

OCTOBER 28, 2024

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 such, clinicians often activate the major haemorrhage protocol based on clinical suspicion, mechanism of injury and the clinical signs of shock.

Frozen Plasma 72

Frozen Plasma FFP Plasma ALS 72

EMDocs

AUGUST 31, 2023

Plasma half-life of the F(ab’) 2 antivenom is significantly longer at 5.5 However, in 2015 crotalidae equine immune F(ab’) 2 (ANAVIP®) was approved by the FDA for rattlesnake envenomations, and distribution of this antivenom began in 2018. This size difference may lead to differences in the pharmacokinetic profiles of the two antibodies.

Allergic Reaction 72

Allergic Reaction Plasma ALS EMS 72

EMDocs

DECEMBER 18, 2023

The first was the suggestion to use balanced crystalloid fluids, such as lactated ringers or plasma-lyte, instead of normal saline. This was based on studies that demonstrated qSOFA was more specific but less sensitive than its counterparts (Table 1). vs. 0.91), positive predictive value (0.27 vs. 0.38), and positive likelihood ratio (5.08

E-9-1-1 65

E-9-1-1 ALS Emergency Department Plasma 65

EMDocs

MARCH 11, 2024

Her facial features were flattened, and her eyes were sunken deep into their sockets. The patient’s breathing was labored, but breath sounds were normal. The abdomen was soft with mild periumbilical tenderness, normoactive bowel sounds, and no rebound or guarding. The extremities were cold with no peripheral edema. cholerae bacteria.

ED 89

ED OR ALS Plasma 89

Pediatric EM Morsels

SEPTEMBER 6, 2024

We talk about a lot of common, not-to-miss diagnoses here at the Morsel Bakery, but we also talk about remaining vigilant for more subtle or uncommon diagnoses. We have spoken about causes to consider when working up a Fever of Unknown Origin including Myocarditis , Osteomyelitis , Acute Rheumatic Fever , and Lemierres syndrome.

Plasma 152

Plasma OR EMS 152