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 FFP Ambulance ICU 111

Don't Forget the Bubbles

JUNE 30, 2023

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. The trauma call goes out. You will be running the show today, and you want to use your preparation time well. The priority is the drain and blood replacement.

E-9-1-1 139

E-9-1-1 FFP Plasma Emergency Department 139

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

EMDocs

JUNE 12, 2024

FFP and platelets also contain citrate. How does this impact what you do in the ED? A meta-analysis found that 56% of patients with severe trauma resulting in hypotension have hypoCa.There was an increase in mortality, increased need for transfusion, and increased risk of coagulopathy in patients with hypoCa. mmol/L to 1.3

ALS 106

ALS FFP Plasma Emergency Department 106

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. 1 Pregnant patients are particularly vulnerable to misdiagnosis of TTP in the ED. creatinine less than 2.0

Frozen Plasma 40

Frozen Plasma Plasma Emergency Department FFP 40

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. A partner at bedside reports recent depressed mood, abdominal pain, and vomiting yesterday. The patient woke up confused this morning, and has had a worsening mental status throughout the day today. Be wary of this stage.

E-9-1-1 98

E-9-1-1 Frozen Plasma Plasma Overdose 98

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 83

E-9-1-1 FFP Critical Care ALS 83

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? Trauma is the most significant contributor to childhood mortality, with the mechanism changing with maturity and social development.

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 The family reports no history of food allergies, insect bites, or contact with sick individuals. The neck is supple with a macular rash present.

ED 75

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