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How and when to reverse anticoagulation in the bleeding EM patient. Comparison between Prothrombin Complex Concentrate (PCC) and Fresh FrozenPlasma (FFP) for the Urgent Reversal of Warfarin in Patients with Mechanical Heart Valves in a Tertiary Care Cardiac Center. Iran J Pharm Res. 2015;14(3):877-885.
Case: A 71-year-old man is brought to your emergency department (ED) by emergency medical serviced (EMS) having fallen two steps at home. EMS have already splinted an obvious mid-shaft femoral fracture, but he continues to be tachycardic and hypotensive. years ( 2 ).
In contrast, protamine could be used for heparin and LMWH reversal and vitamin K, fresh frozenplasma and prothrombinase complex concentrate could be used to reverse coumadin ( Hunt and Levi BMJ 2018 ). This changed in 2015 when the Food and Drug Administration (FDA) approved idarucizumab for the reversal of dabigatran.
Fresh frozenplasma for progressive and refractory angiotensin-converting enzyme inhibitor-induced angioedema. Read More EMCrit: Podcast 145 – Awake Intubation Lecture from SMACC ERCast: Angioedema References: Baş M et al. A randomized trial of icatibant in ACE-inhibitor-induced angioedema. N Engl J Med. 2015; 372(5):418-25.
Reversal of Trauma-Induced Coagulopathy Using First-Line Coagulation Factor Concentrates or Fresh FrozenPlasma (RETIC): A Single-Centre Parallel-Group, Open-Label Randomised Trial. appeared first on REBEL EM - Emergency Medicine Blog. PMID: 36942533 Innerhofer P et al. Lancet Haematol 2017. PMID: 28457980 Jehan F et al.
doi:10.1186/1757-1626-1-16 The post Snake Bites and Children appeared first on Pediatric EM Morsels. (Judge 2019) Best when given within 4 hours of the bite, but still effective within 24 hours Always give an entire vial of antivenom, never a partial vial. It’s expensive, so if you’re giving some of a vial, give it all. Pediatr Nephrol.
Fresh frozenplasma, 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.”
Therapeutic plasma exchange (TPE) with fresh frozenplasma (FFP) is the first-line treatment, by simultaneously supplying fresh ADAMTS13 and removing anti-ADAMTS13 autoantibodies. Dr. Turner originally trained at the Medical University of South Carolina, is an EM intern at Hershey Medical Center in Hershey, PA.
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˚
Coagulopathy: Parenteral vitamin K and/or fresh frozenplasma (FFP) as clinically indicated. Can titrate up to maximum of 40 mg/kg/hr, although hypotension may limit dose of deferoxamine. 10 Maximum daily dose of 6-8g total of defuroxamine. Blood transfusion for clinically significant blood loss.
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