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Podcast 185.0: Anticoagulation Reversal

Core EM

How and when to reverse anticoagulation in the bleeding EM patient. Comparison between Prothrombin Complex Concentrate (PCC) and Fresh Frozen Plasma (FFP) for the Urgent Reversal of Warfarin in Patients with Mechanical Heart Valves in a Tertiary Care Cardiac Center. Iran J Pharm Res. 2015;14(3):877-885.

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EM@3AM: Amniotic Fluid Embolism

EMDocs

We’ll keep it short, while you keep that EM brain sharp. A 37-year-old G5P4 at 33 weeks presents to the ED after being brought in by ambulance. According to EMS, she was in labor at home and delivered the newborn shortly after they had loaded her into the ambulance. link] j.ajog.2016.03.012 2016.03.012 Patel, P.,

EMS 96
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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. Fibrinogen and fibrin are often depleted during major trauma as a result of consumption, breakdown, and dilution. Fibrinogen products may also be needed to stabilize clots and stem bleeding.

FFP 120
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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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Ep 152 The 7 Ts of Massive Hemorrhage Protocols

Emergency Medicine Cases

Why is serum calcium important to draw in the ED for the patient who is exsanguinating? If someone is on anti-platelets or anticoagulants what is the best strategy to ensure the docs in the ED know what to give and how much? What should be the lab resuscitation targets? How do we mitigate the risk of hypothermia?

Plasma 130
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REBEL Core Cast 108.0 – Angioedema

REBEL EM

In: UptoDate, Feldweg AM (ed.) PMID 18768946 Post Created By: Anand Swaminathan MD, MPH (Twitter @EMSwami ) Post Peer Reviewed By: Salim Rezaie MD (Twitter @SRRezaie) The post REBEL Core Cast 108.0 – Angioedema appeared first on REBEL EM - Emergency Medicine Blog. UpToDate, Waltham, MA. Clinical practice. N Engl J Med.

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Penetrating chest trauma

Don't Forget the Bubbles

All you know, back in ED, is that the ETA is 10 minutes, and there is a single stab wound to the chest. The ODP is caught up leaving theatres and has not yet made it down to ED. a) A balanced ratio of 1:1:1 (platelets: FFP: packed red cells) The PROPPR trial showed us that balanced ratios are important. The trauma call goes out.

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