EMDocs

JUNE 3, 2023

The nuances of fracture patterns and delineating mechanically unstable pelvic fractures from stable ones is less important to the ED. This is less critical in ED management of the unstable pelvic fracture, as the optimal site for identification of rectal or vaginal tears is the operating room.

ED 54

ED Operating Room ALS Frozen Plasma 54

REBEL EM

SEPTEMBER 13, 2023

Bradykinin Mediated Plasma globulins called kininogens release bradykinin and cause vascular permeability. Image: ( Morgan 2010 ) Features Absence of urticaria and pruritus Insidious onset (24-36 hours) ACE Inhibitors Inhibition of ACE hinders the degradation of bradykinin and can lead to idiosyncratic angioedema.

Frozen Plasma 104

Frozen Plasma Allergic Reaction FFP Plasma 104

REBEL EM

MAY 25, 2023

JAMA 2015 [7] The PROPPR Trial 680 severely injured adult trauma patients Patients randomized to Plasma, Platelets, and PRBCs in a 1:1:1 ratio vs 1:1:2 ratio No difference in overall mortality at 24 hrs BUT 1:1:1 achieved hemostasis faster and fewer experienced death due to exsanguination at 24hrs Crombie N et al. Anesth Analg 2021.

E-9-1-1 145

E-9-1-1 Plasma ALS OR 145

The Skeptics' Guide to EM

OCTOBER 3, 2021

Some bench work, observational studies, and now two large, unblinded, cluster-randomized single-center trials ( SMART and SALT-ED ) suggested a benefit to using balanced crystalloids (i.e. In the two large trials, this benefit was seen as a reduction in a composite outcome of major adverse kidney events within 30 days (MAKE-30).

OR 130

OR Critical Care ICU Plasma 130

AAEM RSA

APRIL 1, 2021

2,3 Here we examine some of the evidence behind the various components of MTPs, specifically calcium and factor VIIa, and the ratios in which the main products of red blood cells, plasma, and platelets should be administered. What is the ideal blood component ratio for massive transfusion in traumatic hemorrhage? 248(3):447-58.

E-9-1-1 52

E-9-1-1 Plasma ACS ALS 52

EMDocs

JULY 13, 2024

A 37-year-old G2P2 female with no other past medical history presents to the ED with a 2-day history of intermittent fever and foul-smelling vaginal discharge. Therefore, these antibiotics would not be appropriate in the event that the patient had pelvic inflammatory disease or endometritis secondary to chlamydia or gonorrhea.

EMS 64

EMS E-9-1-1 Plasma OR 64

FOAMfrat

AUGUST 15, 2024

Moreover, LTOWB also allows us to administer platelets and plasma, in addition to red cells, to promote clotting and homeostasis. If you don't have access to LTOWB and are administering component therapies such as PRBCs or plasma, this is still incredible and I highly encourage it! Linden JV, Bianco C, eds. Transfusion.

Plasma 69

Plasma Ambulance ALS Emergency Department 69

Don't Forget the Bubbles

JULY 5, 2023

SCD, therefore, is not only a mechanical disease but there are also many other cellular and plasma factors as well as endothelial interaction that generate chronic inflammation. Haematology specialist clinics are key to manage the chronic side of the disease, while ED doctors should be able to act rapidly on the common acute emergencies.

E-9-1-1 126

E-9-1-1 ACS OR ICU 126

EMDocs

DECEMBER 18, 2023

On arrival to the ED, her blood pressure is 84/36 mmHg with a heart rate of 110 beats per minute. 3,4 Prompt recognition and management of sepsis and septic shock are paramount for the ED clinician. 8,9 Recently, monocyte distribution width (MDW) has shown promise in a large meta-analysis as a useful screening tool in the ED.

E-9-1-1 65

E-9-1-1 ALS Emergency Department Plasma 65