EMDocs

JUNE 22, 2024

A 37-year-old G5P4 at 33 weeks presents to the ED after being brought in by ambulance. We’ll keep it short, while you keep that EM brain sharp. She had a precipitous delivery while the ambulance was pulling in. The newborn is doing well, but the mother is complaining of shortness of breath and chest pain.

EMS 111

EMS Ambulance FFP ICU 111

Emergency Medicine Cases

FEBRUARY 9, 2021

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

Plasma ED OR FFP 130

EMDocs

JUNE 12, 2024

FFP and platelets also contain citrate. How does this impact what you do in the ED? Blood products, including both packed red blood cells and whole blood, are stored with the anticoagulant citrate, with can bind Ca and lower ionized Ca levels. grams of citrate per unit. Any transfused blood product can reduce active Ca in the serum.

ALS 105

ALS FFP Plasma Emergency Department 105

ACEP Now

NOVEMBER 16, 2023

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.”

Frozen Plasma 52

Frozen Plasma FFP ALS Plasma 52

Emergency Medicine Ireland

OCTOBER 28, 2020

Not so much for the patient but it’s one of those ones that is niche enough to not have been picked up via the usual filters of ED, medical team to the ward. Theoretically giving them FFP while waiting on PLEX seems like it might be sensible but in reality probably does nothing when the autoantibodies are still around.

Critical Care 40

Critical Care Plasma FFP ICU 40

ACEP Now

APRIL 5, 2024

2 TTP often presents abruptly, and most patients that develop it first visit the emergency department (ED) as their symptoms worsen. 1 Pregnant patients are particularly vulnerable to misdiagnosis of TTP in the ED. Most of these deaths can be attributed to a delay in diagnosis. Thus, early management is essential for patient outcomes.

Frozen Plasma 40

Frozen Plasma Plasma Emergency Department FFP 40

EMDocs

MARCH 18, 2025

Airway: Key decision: base decision for intubation on clinical course, efficacy of airway clearance (coughing, mental status), ED/institutional resources, respiratory status (respiratory failure). Warfarin: vitamin K 10 mg IV and PCC or FFP. Fibrinogen level < 150 mg/dL: cryoprecipitate or fibrinogen concentrate (not FFP).

E-9-1-1 81

E-9-1-1 FFP Critical Care ALS 81

EMDocs

DECEMBER 6, 2024

On arrival to the ED the patient’s initial vital signs are temperature 38.5C, BP 102/48, HR 106, RR 20. Coagulopathy: Parenteral vitamin K and/or fresh frozen plasma (FFP) as clinically indicated. A partner at bedside reports recent depressed mood, abdominal pain, and vomiting yesterday. References: Perrone J. McGraw Hill; 2019.

E-9-1-1 97

E-9-1-1 Frozen Plasma Plasma Overdose 97

Don't Forget the Bubbles

FEBRUARY 5, 2025

Ali, a 12-year-old male, is pre-alerted by ambulance to ED. How would you prepare for the patient’s arrival to ED? Do I have emergency blood available in the ED? Lee, a 14-year-old male, is brought into the ED by his friends, stating he has been in a fight. Which investigations would you consider?

E-9-1-1 59

E-9-1-1 CPR Ambulance ED 59

EMDocs

JANUARY 6, 2025

ED Evaluation Transport to the ED from the refugee reception center takes 1 hour. Labs Laboratory workup in the ED is notable for a leukocytosis of 41,000/L, hemoglobin of 6.5 She is sent to the medical ward after three days in the ED with the diagnoses of resolving septic shock, severe malaria, and AKI.

ED 75

ED E-9-1-1 ALS Emergency Department 75