The Skeptics' Guide to EM

DECEMBER 17, 2022

Case: A 71-year-old man is brought to your emergency department (ED) by emergency medical serviced (EMS) having fallen two steps at home. The transfusion tech calls to remind you that your protocol is currently under review, and asks if would you like the 1:1 or the 1:3 version of fresh-frozen plasma (FFP) to packed red blood cells (pRBC)?

Frozen Plasma 130

Frozen Plasma FFP Emergency Medical Services Plasma 130

REBEL EM

SEPTEMBER 13, 2023

Without the C1 inhibitor, the plasma-kallikrein-kinin system produces more bradykinin. 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 ).

Frozen Plasma 101

Frozen Plasma Allergic Reaction FFP Plasma 101

Core EM

JANUARY 24, 2024

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. Background Around 6 million people in the U.S. Background Around 6 million people in the U.S.

FFP 130

FFP Frozen Plasma Plasma ALS 130

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

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

JUNE 3, 2023

The nuances of fracture patterns and delineating mechanically unstable pelvic fractures from stable ones is less important to the ED. Her initial vital signs are blood pressure 76/54 mmHg, heart rate 128 bpm, temperature 37.0˚ C, respiratory rate 20 breaths per minute, and oxygen saturation 95% on room air. of pelvic fractures to be open.

ED 61

ED Operating Room ALS Frozen Plasma 61

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 96

E-9-1-1 Frozen Plasma Plasma Overdose 96