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Hosts: Joe Offenbacher, MD Audrey Bree Tse, MD [link] Download Leave a Comment Tags: Anticoagulation , Critical Care , 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. Ann Emerg Med.
Click here for Direct Download of the Podcast Paper: Bouzat P et al. References: Bouzat P et al. PMID: 36942533 Innerhofer P et al. High-quality studies are needed to determine the utility of this intervention. REBEL Cast Ep118: The PROCOAG Trial – 4F-PCC in Trauma Patients? to 3.33; P = 0.72 to 2.10; P = 0.03
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.
Read More EMCrit: Podcast 145 – Awake Intubation Lecture from SMACC ERCast: Angioedema References: Baş M et al. PMID 25629740 Hassen GW et al. PMID 23062323 Kostis JB et al. PMID 16043683 McCormick M et al. PMID 20954277 Sinnert R et al. Zuraw et al. N Engl J Med. 2015; 372(5):418-25. 2013;24:53-66.
Date: December 16th, 2022 Reference: Hohle et al. Date: December 16th, 2022 Reference: Hohle et al. The transfusion tech calls to remind you that your protocol is currently under review, and asks if would you like the 1:1 or the 1:3 version of fresh-frozen plasma (FFP) to packed red blood cells (pRBC)? years ( 2 ).
Most major hemorrhage protocols give a balanced transfusion of PRBCs, FFP, and platelets in ratios approaching concentrations found in whole blood. Paper: Davenport R et al. References: Davenport R et al. Fibrinogen products may also be needed to stabilize clots and stem bleeding. Cryoprecipitate Group: 25.3% to 1.23; p = 0.74
FFP and platelets also contain citrate. Giancarelli et al found that 97% of patients who underwent massive transfusion protocols during trauma resuscitation were hypocalcemic (iCa < 1.1 Kyle et al demonstrated that transfusing a single unit of pRBCs can lead to significant decreases in Ca. Byerly S, Inaba K, Biswas S, et al.
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. Laan DV, Vu TD, Thiels CA et al. And blood comes out. Quite quickly.
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. Were these providers blinded?
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.
Therapeutic plasma exchange (TPE) with fresh frozen plasma (FFP) is the first-line treatment, by simultaneously supplying fresh ADAMTS13 and removing anti-ADAMTS13 autoantibodies. References Sukumar S, Lämmle B, et al. Kessler CS, Khan BA, et al. Li XM, Mo XY, et al. 2021;46:556-9 Long B, Bridwell RE, et al.
Karageorgos S, Ren D, Ranaweera M, et al. Major haemorrhage protocols typically include a mixture of packed red blood cells (pRBCs), platelets, and fresh frozen plasma (FFP). Platelets and FFP replace lost platelets and coagulation factors, which help with clotting and also provide some volume expansion. Am J Emerg Med.
Warfarin: vitamin K 10 mg IV and PCC or FFP. Fibrinogen level < 150 mg/dL: cryoprecipitate or fibrinogen concentrate (not FFP). Ittrich H, Bockhorn M, Klose H, et al. Mondoni M, Carlucci P, Job S, et al. Fartoukh M, Khoshnood B, Parrot A, et al. Razazi K, Parrot A, Khalil A, et al. microg/kg IV.
A: Balanced blood product transfusion 3 pRBC:2 FFP:1 Platelets B: Calcium replacement C: Avoid hypothermia D: Avoid acidosis E: Replace cryoprecipitate to target normal fibrinogen Answer 4 The correct answer is A. Question 4 Which is not a key aspect of fluid resuscitation in trauma? link] Faculty of Forensic and Legal Medicine.
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