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Hosts: Joe Offenbacher, MD Audrey Bree Tse, MD [link] Download Leave a Comment Tags: Anticoagulation , CriticalCare , Resuscitation Show Notes Coagulation Cascade: Algorithm for Anticoagulated Bleeding Patient in the ED: Indications for Anticoagulation Reversal: References: Baugh CW, Levine M, Cornutt D, et al.
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. Scully, 2012) Citations: Balduini CL, et al. Paydary, Koosha, et al. Sawler D, Parker A, Britto J, et al. Ann Hematol. J Emerg Med.
Treatment is supportive with respiratory therapy, criticalcare, inotropic therapy, and cardiac life support. If AFE occurs during labor, immediate delivery is recommended. ” Obstet Gynecol 123(2 Pt 1): 337-348. link] Society for Maternal-Fetal Medicine. Electronic address, p. ” Am J Obstet Gynecol 215(2): B16-24.
Fresh frozen plasma, or FFP, should only be given to cirrhotic patients as part of the massive transfusion protocol in cases of profound hypotension, as “patients with cirrhosis rarely have true enzymatic hypocoagulability, and FFP may worsen bleeding due to over-resuscitation and dilution of coagulation factors.” Crit Care Med.
Warfarin: vitamin K 10 mg IV and PCC or FFP. Fibrinogen level < 150 mg/dL: cryoprecipitate or fibrinogen concentrate (not FFP). Consultation needed for definitive management: Pulmonology/criticalcare, IR, and cardiothoracic surgery; admission to the criticalcare setting (likely requires transfer).
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