REBEL EM

SEPTEMBER 13, 2023

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 Without the C1 inhibitor, the plasma-kallikrein-kinin system produces more bradykinin. J Emerg Med 2013; 44 (4): 764-772. N Engl J Med. 2015; 372(5):418-25.

Frozen Plasma 101

Frozen Plasma Allergic Reaction FFP Plasma 101

Don't Forget the Bubbles

JUNE 30, 2023

This was a randomised controlled multisite study comparing resuscitation of trauma patients requiring massive transfusion using either 1:1::1 or 1:1:2 ratios of platelets to plasma to red blood cells. Interim results presented earlier this year show that REBOA performed within the Emergency Department increased mortality.

E-9-1-1 139

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

EMDocs

SEPTEMBER 7, 2023

DEG is rapidly absorbed when ingested and can reach peak plasma and brain tissue concentrations within four hours of ingestion. 2 Laboratory assays for DEG are not widely available and have long turn-around-times, thus have limited utility in diagnosis in the emergency department.

E-9-1-1 87

E-9-1-1 ALS Plasma Emergency Department 87

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. It is thus imperative that emergency physicians be able to recognize and properly treat this disease, especially in the absence of its classical presentation. J Emerg Med. Am J Emerg Med.

Frozen Plasma 40

Frozen Plasma Plasma Emergency Department FFP 40

FOAMfrat

AUGUST 15, 2024

The midwives report that EMS is not needed for the baby. But, from a basic care perspective, I am not sure there is anything that the average EMS crew would do differently, despite this case being anything but basic. The midwives go on to explain that following the baby’s birth, the patient began to hemorrhage.

Plasma 69

Plasma Ambulance ALS Emergency Department 69

EMDocs

AUGUST 7, 2023

Schnapp, MD, MEd (Associate Program Director, University of Wisconsin) // Reviewed by: Joshua Lowe, MD (EM Attending Physician, USAF), Marina Boushra (EM-CCM, Cleveland Clinic Foundation); Brit Long, MD (@long_brit) Case A 36-year-old pregnant woman at 21 weeks gestation presents to the ED with chest pain. Ann Emerg Med.

E-9-1-1 91

E-9-1-1 ALS Plasma OR 91

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.” Acad Emerg Med.

Frozen Plasma 52

Frozen Plasma FFP ALS Plasma 52

EMDocs

DECEMBER 18, 2023

Today, she would not get out of bed, prompting the facility to call EMS. The first was the suggestion to use balanced crystalloid fluids, such as lactated ringers or plasma-lyte, instead of normal saline. Proadrenomedullin in Sepsis and Septic Shock: A Role in the Emergency Department. She had a fever of 38.7 °C

E-9-1-1 86

E-9-1-1 ALS Emergency Department Plasma 86

EMDocs

JUNE 3, 2023

What is the EM physician’s role in the stabilization of unstable pelvic injuries? If a pelvic binder was placed by EMS, inquire whether this was placed empirically or if mechanical pelvic instability was already elicited. Her initial vital signs are blood pressure 76/54 mmHg, heart rate 128 bpm, temperature 37.0˚

ED 61

ED Operating Room ALS Frozen Plasma 61

EMDocs

JUNE 7, 2023

8 Plasma butyrylcholinesterase (“pseudocholinesterase”) activity Easier to assay and is more widely available Red cell acetylcholinesterase (“true cholinesterase”) activity More accurate and specific Management: Patients require immediate intervention if there is concern for acute organophosphate poisoning. BMC Res Notes. 2013; 6:524.

E-9-1-1 98

E-9-1-1 ICU Emergency Department ED 98

EMDocs

JUNE 14, 2023

Parenteral organophosphorus poisoning in a rural emergency department: a case report. Two assays available used to help confirm diagnosis, however, do not guide treatment Low levels of activity are consistent with organophosphate poisoning. These are send-out labs with turn-around times that make them unlikely to affect the ED course.

E-9-1-1 92

E-9-1-1 Plasma Emergency Department ACS 92

ACEP Now

FEBRUARY 11, 2025

A 33-year-old male with a history of drug use presented to the emergency department (ED) for extreme agitation after receiving two doses of 2 mg naloxone by EMS for respiratory depression. The addictive potential and challenges with use of the herbal supplement kratom: a case report and literature review. 2022;23(1):4-9.

NARCAN 89

NARCAN Naloxone Overdose Mental Health Services 89

EMDocs

DECEMBER 6, 2024

Antidote : Deferoxamine is a chelating agent derived from Streptomyces pilosus ; binds free iron from plasma and iron inside of cells. 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.

E-9-1-1 96

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

FOAMfrat

NOVEMBER 25, 2024

Earlier in the summer, I wrote a blog discussing the challenges, intricacies, and educational pitfalls of postpartum hemorrhage in EMS. For patients suffering from intrapartum cardiac arrest, I would encourage you to transport the patient as expeditiously, but safely, as possible to the closest emergency department.

Epinephrine 105

Epinephrine CPR Operating Room Plasma 105

EMDocs

FEBRUARY 3, 2025

Collins, MD (EM Resident Physician, San Antonio, Texas); Michael J. Treatment requiresaggressive anticoagulation, glucocorticoids, plasma exchange, and intravenous immunoglobulin (IVIG)(27). Authors: William J. This leads to adiffuse hypercoagulable state and widespread vascular dysfunction.

ED 66

ED E-9-1-1 ALS OR 66

Core EM

JANUARY 16, 2025

An EM Residents Guide to Basic Airway Management Authors: Justin Rice, MD Sagar Desai, MD Eunice Monge, MD William Chiang, MD Preface: Airway management is one of the most critical skills in emergency medicine, yet it can be one of the most challenging to master. Ann Emerg Med. ” Academic Emergency Medicine 26.9

EMS 130

EMS E-9-1-1 ALS OR 130

EMDocs

MARCH 11, 2024

Authors: Gaston Omba, MD (EM Resident Physician, Makerere University); Jessica Pelletier, DO (EM Education Fellow, Washington University in St. 30 Moreover, OCVs administered to children in endemic regions could provide herd immunity to unvaccinated adults, but the effect in unvaccinated children requires further study.

ED 109

ED ALS OR Plasma 109

EMDocs

JANUARY 6, 2025

HIV Prevention and Treatment: The Evolving Role of the Emergency Department. Ann Emerg Med. Undernourished children presenting to an urban emergency department of a tertiary hospital in Tanzania: a prospective descriptive study. Use of Medical Interpreters in the Emergency Department.; 2017;3:17067.

ED 73

ED E-9-1-1 ALS Emergency Department 73