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Penetrating chest trauma

Don't Forget the Bubbles

a) A balanced ratio of 1:1:1 (platelets: FFP: packed red cells) The PROPPR trial showed us that balanced ratios are important. b) A balanced ratio of 1: 1:2 (platelets: FFP: packed red cells) The PROPPR trial showed us that balanced ratios are important. And blood comes out. Quite quickly. Time to get a transfusion started.

E-9-1-1 139
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TEG-Guided Resuscitation of Patients with Cirrhosis and Non-Variceal Bleeding

REBEL EM

A meta-analysis of fifteen RCTs comparing blood product transfusion rates of cardiothoracic and surgery patients found significantly lower transfusion rates of FFP in TEG/ROTEM guided group compared to traditional tests, with no difference in survival rates (Fahrendorff 2017). Article: Kumar M et al.

FFP 52
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Best Practices for Upper Gastrointestinal Hemorrhage

ACEP Now

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.” Am J Emerg Med.

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A guide to major haemorrhage management in paediatrics

Don't Forget the Bubbles

Karageorgos S, Ren D, Ranaweera M, et al. Surprisingly, there are different definitions of paediatric major haemorrhage, with no single agreed-upon definition. Many of these definitions are not useful in acutely bleeding children as they require measuring the amount of blood that was lost or transfused over prolonged periods.

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emDOCs Podcast – Episode 116: Massive Hemoptysis

EMDocs

Episode 116: Massive Hemoptysis Definition: Hemoptysis is expectoration of blood from the respiratory tract; ranges from mild with small streaks of blood to cardiopulmonary compromise (1-5). Massive hemoptysis: no clear definition, ranges from 50 mL in a single expectoration to 100 mL in 24 hours to over 1 L in 48 hours. microg/kg IV.

E-9-1-1 84
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ED care of refugee populations from sub-Saharan Africa

EMDocs

57 Adapted from: Long B, MacDonald A, Liang SY, et al. link] Rother B, Pierre G, Lombardo D, et al. link] Franco JR, Cecchi G, Priotto G, et al. Biggs H, Behravesh CB, Bradley KK et al. Cholera Case Definitions and Diagnosis.; 57 Table 2. Malaria treatment options. The American Journal of Emergency Medicine.

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