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Anticoagulation Reversal

Core EM

2017.09.1085 Gómez-Outes A, Alcubilla P, Calvo-Rojas G, et al. 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. J Am Coll Cardiol.

FFP 130
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Thrombotic Thrombocytopenic Purpura (TTP)

Core EM

Renal injury: isolated proteinuria or hematuria, moderate acute kidney injury with serum creatinine levels <2 mg/dL Skin: petechiae and purpura Despite severe thrombocytopenia, clinically significant bleeding is rare Figure 1.

Plasma 246
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CRYOSTAT-2: Early Empiric Cryoprecipitate in Major Trauma

REBEL EM

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. Fibrinogen products may also be needed to stabilize clots and stem bleeding. Cryoprecipitate Group: 25.3% OR 0.96; 95% CI 0.75 to 1.23; p = 0.74 to 1.23; p = 0.74

FFP 127
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EM@3AM: Amniotic Fluid Embolism

EMDocs

A) Amniotic fluid embolism B) Eclampsia C) Placental abruption D) Pulmonary embolism Answer: A Amniotic fluid embolism (AFE) is a rare but potentially fatal complication of pregnancy. AFE should be considered in a patient who experiences cardiorespiratory collapse during labor or shortly thereafter.

EMS 96
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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.”

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REBEL Core Cast 108.0 – Angioedema

REBEL EM

of people who take NSAIDs ( Nzeako 2010 ). patients that take ACE inhibitors (but 20-30% of all angioedema presentations to the Emergency Department) 3 times more common in Black Americans ( Kostis 2005 ) 0.01 of people who take NSAIDs ( Nzeako 2010 ). Typically involves the mouth, larynx, pharynx, and subglottic tissue ( Kostis 2005 ).

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

REBEL EM

Click here for Direct Download of the Podcast Paper: Bouzat 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? Severe acute traumatic coagulopathy = PT >1.5 to 3.33; P = 0.72 to 2.10; P = 0.03 to 3.33; P = 0.72 to 2.10; P = 0.03

FFP 145