Core EM

JANUARY 24, 2024

Anticoagulant Reversal Strategies in the Emergency Department Setting: Recommendations of a Multidisciplinary Expert Panel. Ann Emerg Med. Background Around 6 million people in the U.S. Reversal of oral anticoagulation in patients with acute intracerebral hemorrhage. 2019;23(1):206. Published 2019 Jun 6. 2020;76(4):470-485.

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FFP Frozen Plasma Plasma ALS 130

EMDocs

AUGUST 7, 2023

7 The American College of Emergency Physicians (ACEP) clinical policy supports the use of age-adjusted D-dimer testing when evaluating for VTE in older patients. 2014.2135 American College of Emergency Physicians Clinical Policies Subcommittee (Writing Committee) on Thromboembolic Disease:, Wolf SJ, Hahn SA, et al. Ann Emerg Med.

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Core EM

JANUARY 25, 2024

link] ) Laboratory Evaluation: Clinical presentation and laboratory findings can help suggest TTP in the emergency department. Joly, 2017; Sawler, 2020) Fresh frozen plasma (FFP) (contains ADMTS-13) may be used to supplement ADAMTS-13 if there is a delay in initiating TPE in the emergency department (i.e.

Plasma 246

Plasma Frozen Plasma Emergency Department FFP 246

EMDocs

MARCH 4, 2024

Darnall Army Medical Center) // Reviewed by: Joshua Lowe, MD (EM Attending Physician, USAF); Marina Boushra (EM-CCM, Cleveland Clinic Foundation); Brit Long, (@long_brit) Disclaimer: The views expressed in this post are those of the authors and do not reflect the official policy or position of the Department of the Army, DoD, or the US Government.

Emergency Department 105

Emergency Department E-9-1-1 ALS OR 105

The Skeptics' Guide to EM

DECEMBER 17, 2022

Kirsty Challen is a Consultant in Emergency Medicine at Lancashire Teaching Hospitals. Case: A 71-year-old man is brought to your emergency department (ED) by emergency medical serviced (EMS) having fallen two steps at home. years ( 2 ).

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Frozen Plasma FFP Emergency Medical Services Plasma 130

EMDocs

JULY 11, 2023

The patient’s plasma is mixed with normal pooled plasma (NPP) which adds sufficient clotting factors to overcome the deficiency. If an inhibitor is present, it will inhibit the clotting factors in patient plasma and the NPP, and the clotting time remains prolonged. Each unit of FVIII/kg raises the plasma FVIII level by 2%.

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Plasma ALS OR Emergency Department 75

Pediatric EM Morsels

AUGUST 9, 2024

Neonates presenting to the Emergency Department often cause a lot of uncertainty. Let’s review how Congenital Syphilis may present to our Emergency Departments: Congenital Syphilis : Basics Occurs when the spirochete Treponema pallidum is transmitted from mother to fetus. Is this scalp swelling normal?

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EMDocs

DECEMBER 18, 2023

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. Procalcitonin and sepsis in the Emergency Department: an update. Intensive Care Med. 2021;57(9):920.

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E-9-1-1 ALS Emergency Department Plasma 90

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.

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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. 1 Dr. J Emerg Med.

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Frozen Plasma Plasma Emergency Department FFP 40

Don't Forget the Bubbles

AUGUST 12, 2024

What neuroprotective measures can we undertake in the emergency department? Neuroprotective measures are undertaken in the emergency department and PICU to optimise intracerebral conditions, minimise secondary brain injury, and create optimal tissue healing conditions.

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ALS Emergency Department Plasma OR 75

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.

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E-9-1-1 ALS Emergency Department Plasma 91

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! Like I said, some blood is better than no blood!

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Plasma Ambulance ALS Emergency Department 69

EMDocs

JUNE 12, 2024

Two randomized controlled trials by Moore et al found that prehospital plasma administration in trauma patients is associated with hypoCa (53% vs 36%). Ionised calcium levels in major trauma patients who received blood in the Emergency Department. Emerg Med J. How does this impact the prehospital environment?

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ALS FFP Plasma Emergency Department 106

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.

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Frozen Plasma FFP ALS Plasma 52

ACEP Now

APRIL 2, 2024

An 18-year-old woman presented to the emergency department (ED) with symptoms of nausea, vomiting, diarrhea, and abdominal pain. Ann Emerg Med. Quantification of hypoglycin A and methylenecyclopropylglycine in human plasma by HPLC-MS/MS. Since the onset of illness, she had been unable to tolerate any oral intake.

Plasma 40

Plasma ALS Emergency Department ED 40

Don't Forget the Bubbles

OCTOBER 28, 2024

doi: 10.1136/archdischild-2024-327224 Six-year-old Rhaenyra is brought into the emergency department after being hit by a car. Major haemorrhage protocols typically include a mixture of packed red blood cells (pRBCs), platelets, and fresh frozen plasma (FFP). Published Online First: 24 June 2024. 2024;19(5):e0303109.

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FFP Frozen Plasma Plasma ALS 72

FOAMfrat

SEPTEMBER 19, 2024

Along with inducing coagulopathy, venom toxins may contribute to local and/or systemic hemorrhage and plasma extravasation by means of basement membrane degradation within the vasculature. Rattlesnake Envenomation Treatment & Management: Prehospital Care, Emergency Department Care, Consultations.” Accessed 10 July 2024.

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Emergency Department Epinephrine OR Plasma 95

EMDocs

JUNE 3, 2023

Institutional protocols should be utilized, keeping in mind that either whole blood or a 1:1:1 ratio of packed red blood cells, platelets, and fresh frozen plasma are optimal. Her initial vital signs are blood pressure 76/54 mmHg, heart rate 128 bpm, temperature 37.0˚

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ED Operating Room ALS Frozen Plasma 64

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. Upon arrival, his vitals were as follows: heart rate of 132 bpm, respiratory rate of 27, blood pressure of 134/75 mm Hg, and a SpO 2 of 100 percent.

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NARCAN Naloxone Overdose Mental Health Services 89

Don't Forget the Bubbles

MARCH 24, 2025

Later phase : As plasma levels fall, vasoconstriction decreases. A recent REPEM survey across Europe found that up to 10% of Emergency Departments use Dexmed for procedural sedation in children. Dexmed is not widely used in the emergency department but may have future roles in paediatric procedural sedation.

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E-9-1-1 Emergency Department ALS Critical Care 59

EMDocs

JUNE 14, 2023

Parenteral organophosphorus poisoning in a rural emergency department: a case report. He has been having difficulty walking and is having trouble manipulating tools he uses for work with his hands. These are send-out labs with turn-around times that make them unlikely to affect the ED course. link] Updated September 14, 2020.

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E-9-1-1 Emergency Department Plasma ED 95

EMDocs

FEBRUARY 3, 2025

Treatment requiresaggressive anticoagulation, glucocorticoids, plasma exchange, and intravenous immunoglobulin (IVIG)(27). She also reports a fever (maximum 101F), photosensitivity, and mild abdominal discomfort radiating to both flanks, accompanied by some shortness of breath.

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ED E-9-1-1 ALS OR 69

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.

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

EMDocs

JANUARY 22, 2025

Is there an ideal observation period in the emergency department after reversal with naloxone? Profound increase in epinephrine concentration in plasma and cardiovascular stimulation after mu-opioid receptor blockade in opioid-addicted patients during barbiturate-induced anesthesia for acute detoxification. Acad Emerg Med.

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Naloxone E-9-1-1 Overdose NARCAN 96

FOAMfrat

NOVEMBER 25, 2024

Resuscitating patients with low titer O whole blood or with component therapy in a ratio of 1:1:1, with packed red blood cells, platelets, and plasma, is impactful as it will help promote the restoration of circulation and add platelets and hemoglobin to the depleted store.

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Epinephrine CPR Operating Room Plasma 105

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.

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Core EM

JANUARY 16, 2025

This graph shows the gaseous equivalent volume of oxygen stored in the lungs, bound to hemoglobin, and dissolved in the plasma for people breathing room air (far left) vs the same people pre-oxygenated by breathing 100% O2 (far right), and then after they have desatted to 90% while apneic (center). Ann Emerg Med. Ann Emerg Med.

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Emergency Medicine Ireland

MARCH 4, 2021

GBS is a clinically important diagnosis for both the emergency department and the ICU. GBS is a clinically important diagnosis for both the emergency department and the ICU. Its rareish but common enough that you. Read More » Welcome back to the tasty morsels of critical care podcast.

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Critical Care ICU Plasma Emergency Department 40

EMDocs

MARCH 11, 2024

Louis) // Reviewed by: Joshua Lowe, MD (EM Staff Physician, USAF); Alex Koyfman, MD (@EMHighAK); Brit Long, MD (@long_brit) Case A 25-year-old woman presented to the emergency department (ED) in Uganda with acute encephalopathy.

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ED OR ALS Plasma 111

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. A 6-year-old girl from Saudi Arabia was referred by her General Practitioner to the local emergency department.

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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.

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