Handtevy

DECEMBER 23, 2024

Empowering fire and EMS professionals to save lives requires access to the latest innovations in prehospital care. Whole blood transfusion programs have revolutionized trauma care, providing critical resources to stabilize patients in the field and improve survival outcomes.

NFPA 52

NFPA Plasma Emergency Response EMS 52

Chicago EMT Training

AUGUST 6, 2021

So when it comes time to renewing your certification or license, you'll have to directly correspond with the IDPH rather than an EMS Coordinator within a system. Standby EMS for events The company that comes to mind in Chicago is Event Medical Solutions. The biggest event they provide EMS for recently is Lollapalooza.

EMT 130

EMT EMT Paramedic Plasma 130

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. EMS have already splinted an obvious mid-shaft femoral fracture, but he continues to be tachycardic and hypotensive. years ( 2 ).

Frozen Plasma 130

Frozen Plasma FFP Emergency Medical Services Plasma 130

Core EM

JULY 23, 2024

Hyperkalemia Cardiac conduction partially depends on a gradient of lower extracellular (plasma) potassium levels and higher intracellular potassium levels. For further discussion on Hyperkalemia and the Hyperkalemic ECG, see Core EM Podcast Episode 189: Episode 189: Hyperkalemia 2.0 His EKG on discharge is shown below.

Plasma 130

Plasma Emergency Department Overdose OR 130

REBEL EM

SEPTEMBER 13, 2023

Bradykinin Mediated Plasma globulins called kininogens release bradykinin and cause vascular permeability. Image: ( Morgan 2010 ) Features Absence of urticaria and pruritus Insidious onset (24-36 hours) ACE Inhibitors Inhibition of ACE hinders the degradation of bradykinin and can lead to idiosyncratic angioedema.

Frozen Plasma 105

Frozen Plasma Allergic Reaction FFP Plasma 105

Emergency Medicine Cases

FEBRUARY 9, 2021

Until the results of lab testing come back and hemorrhage pace is slowed, what ratio of plasma to RBCs should we target? If someone is on anti-platelets or anticoagulants what is the best strategy to ensure the docs in the ED know what to give and how much? What's better, 1:1:1 or 2:1:1? Should we ever consider using Recombinant Factor 7a?

Plasma 130

Plasma ED OR FFP 130

Core EM

JANUARY 24, 2024

Hyperkalemia Cardiac conduction partially depends on a gradient of lower extracellular (plasma) potassium levels and higher intracellular potassium levels. For further discussion on Hyperkalemia and the Hyperkalemic ECG, see Core EM Podcast Episode 189: Episode 189: Hyperkalemia 2.0 His EKG on discharge is shown below.

Plasma 130

Plasma Emergency Department Overdose OR 130

The Overrun Podcast

MAY 23, 2019

Dan recaps the MD1 EMS Conference and shares what he learned from a room full of EM/EMS physicians speaking to EMS clinicians! link] Ultrasound in Cardiac Arrest: [link] Happy EMS Week! We're heading to the MD1/EMS and Disaster Medicine Fellowship Conference at Newark Beth Israel Medical Center!

EMS 52

EMS Plasma Epinephrine CPR 52

The Skeptics' Guide to EM

APRIL 6, 2019

In contrast, protamine could be used for heparin and LMWH reversal and vitamin K, fresh frozen plasma and prothrombinase complex concentrate could be used to reverse coumadin ( Hunt and Levi BMJ 2018 ). Level A One of the concerns clinicians had with DOACs was there was no way to reverse these new anti-coagulants when they were introduced.

Frozen Plasma 130

Frozen Plasma Plasma ALS EMS 130

Pediatric EM Morsels

JUNE 14, 2024

doi:10.1177/0883073812452916 The post Acute Transverse Myelitis in Children appeared first on Pediatric EM Morsels. Journal of child neurology vol. 27,11 (2012): 1426-36.

Plasma 143

Plasma ALS OR EMS 143

EMDocs

APRIL 10, 2024

Authors: Alex Rogers, MD (EM Resident Physician, Christus Spohn/Texas A&M University School of Medicine, Corpus Christi, TX); J.D. Metabolism of ester anesthetics is by plasma cholinesterase, whereas amides are metabolized by the cytochrome P450 system in the liver. [6] 2] This linking group can be either an amide (e.g.,

E-9-1-1 111

E-9-1-1 Plasma Epinephrine Life Support 111

The Skeptics' Guide to EM

OCTOBER 3, 2021

Case: A 66-year-old woman is brought in by EMS from home with lethargy and hypotension. Clinical Question: Does administration of a balanced solution (Plasma-Lyte 148) during intensive care unit (ICU) stay, compared with saline solution, result in improved 90-day survival in critically ill patients? Reference: Zampieri et al.

OR 130

OR Critical Care ICU Plasma 130

EMDocs

MAY 23, 2024

3 Measured in analytical testing : Laboratories measure plasma concentration using osmometers which measures values as a function of kilograms of solvent. Choice of the best equation for plasma osmolality calculation: Comparison of fourteen formulae. Validation of equations used to predict plasma osmolality in a healthy adult cohort.

Plasma 91

Plasma EMS ED OR 91

REBEL EM

MAY 25, 2023

JAMA 2015 [7] The PROPPR Trial 680 severely injured adult trauma patients Patients randomized to Plasma, Platelets, and PRBCs in a 1:1:1 ratio vs 1:1:2 ratio No difference in overall mortality at 24 hrs BUT 1:1:1 achieved hemostasis faster and fewer experienced death due to exsanguination at 24hrs Crombie N et al. Ann Emerg Med.

E-9-1-1 145

E-9-1-1 Plasma ALS OR 145

Pediatric EM Morsels

AUGUST 9, 2024

The post Congenital Syphilis appeared first on Pediatric EM Morsels. Can identify T. pallidum before antibodies against it can be detected. > 4 weeks of age : Aqueous crystalline penicillin G 50,000 Units/kg IV every 6 hours Treat for 10-14 days. A case of congenital syphilis. Emerg Radiol. 2013 Aug;20(4):337-9. Epub 2013 Feb 27.

E-9-1-1 154

E-9-1-1 Plasma Emergency Department OR 154

EMDocs

AUGUST 31, 2023

Plasma half-life of the F(ab’) 2 antivenom is significantly longer at 5.5 F(ab) is smaller, consisting of a single antigen binding site, while F(ab’) 2 consists of two antigen-binding sites linked together by an antibody “hinge” region. This size difference may lead to differences in the pharmacokinetic profiles of the two antibodies.

Allergic Reaction 97

Allergic Reaction Plasma ALS EMS 97

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. Pragmatic Randomized Optimal Platelet and Plasma Ratios (PROPPR) Trial: design, rationale and implementation. to −0.5%]; P  = 0.03.).

E-9-1-1 139

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

Critical Care Scenarios

OCTOBER 31, 2021

Boswell (EM and CCM) of the University of Maryland, perhaps the busiest center in the country for COVID-related ECMO. Boswell (EM and CCM) of the University of Maryland, perhaps the busiest center in the country for COVID-related ECMO. An overview of VV ECMO with a focus on COVID-19, with Dr. Kimberly A.

Interfacility Transport 100

Interfacility Transport Plasma ICU EMS 100

REBEL EM

JUNE 26, 2023

Reversal of Trauma-Induced Coagulopathy Using First-Line Coagulation Factor Concentrates or Fresh Frozen Plasma (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.

FFP 145

FFP Frozen Plasma ALS Plasma 145

The Overrun

JUNE 3, 2023

Born out of military medicine experience, we are starting to see civilian EMS programs both air and ground starting to use this treatment to save lives from traumatic injury and massive hemorrhage. Through the years, we see a change to plasma, then crystalloid, and then 1:1:1 therapy. But what exactly is going on? link] Ponschab, M.,

Plasma 52

Plasma Paramedicine Paramedicine EMS 52

Pediatric EM Morsels

MARCH 17, 2023

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.

Frozen Plasma 130

Frozen Plasma Plasma First Aid OR 130

The EMS Show

NOVEMBER 17, 2023

We took some time to get to know Dr. Guyette and talk some EMS Research! PACT Trial: [link] Prehospital Plasma during Air Medical Transport in Trauma Patients at Risk for Hemmorhagic Shock: [link]

Medical Transportation 40

Medical Transportation Plasma EMS 40

The EMS Show

NOVEMBER 17, 2023

We took some time to get to know Dr. Guyette and talk some EMS Research! PACT Trial: [link] Prehospital Plasma during Air Medical Transport in Trauma Patients at Risk for Hemmorhagic Shock: [link]

Medical Transportation 40

Medical Transportation Plasma EMS 40

EMDocs

SEPTEMBER 7, 2023

DEG is rapidly absorbed when ingested and can reach peak plasma and brain tissue concentrations within four hours of ingestion. Pharmacokinetics: 2 No minimal toxic dose has been established, however, doses up to 22 mg seem to be safe for adults from the available literature.

E-9-1-1 92

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

EMDocs

MARCH 4, 2024

Authors: Amelia Campbell, MD (EM Resident Physician, Carl R. Darnall Army Medical Center) and Alec Pawlukiewicz, MD (EM Attending Physician, Carl R. 1 GGT is an enzyme located on the plasma membrane of hepatocytes that is involved in the regeneration of glutathione.

Emergency Department 105

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

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.

E-9-1-1 95

E-9-1-1 ALS Plasma OR 95

ACEP Now

APRIL 5, 2024

Therapeutic plasma exchange (TPE) with fresh frozen plasma (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. J Clin Med.

Frozen Plasma 40

Frozen Plasma Plasma Emergency Department FFP 40

Dr. Smith's ECG Blog

APRIL 6, 2018

EMS report was that the patient had unknown down time with unwitnessed arrest, found initially in VFib arrest, defibrillated x1 followed by PEA arrest alternating with asystolic arrest during transport. Terbutaline and Albuterol for Lowering of Plasma Postassium Initial labs returned and confirmed critical hyperkalemia and new renal failure.

Defibrillator 52

Defibrillator ICU EMS Plasma 52

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.” 6 Balloon tamponade (i.e.,

Frozen Plasma 52

Frozen Plasma FFP ALS Plasma 52

REBEL EM

NOVEMBER 28, 2022

Xian 2019) 4-Factor Prothrombin Complex Concentrates (4F-PCC), or K-Centra, is a derivative of human plasma and is explicitly used to reverse vitamin K antagonists such as warfarin and non-specifically in the reversal of DOACs. Andexanet alfa (AA) is a decoy protein specific to the emergent reversal of Factor Xa inhibitor-associated bleeding.

OR 52

OR Plasma ALS EMS 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. The patient currently resides at a skilled nursing facility. She had a fever of 38.7 °C F) in the ambulance.

E-9-1-1 91

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

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 64

ED Operating Room ALS Frozen Plasma 64

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.

E-9-1-1 98

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

EMDocs

JUNE 14, 2023

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. 3 However, may be helpful in diagnosing the chronic toxicity forms.

E-9-1-1 95

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

Pediatric EM Morsels

SEPTEMBER 6, 2024

The post Kikuchi-Fujimoto Disease appeared first on Pediatric EM Morsels. Kikuchi-Fujimoto Disease Genetic and Rare Diseases Information Center. Available at: [link] (Accessed: 02 September 2024).

Plasma 154

Plasma OR EMS 154

EMDocs

JULY 19, 2023

However, in extreme cases with highly toxic levels, one could consider plasma exchange if no other suitable alternative exists. Chelation is generally indicated in cases where patients are experiencing symptoms of toxicity (even the vague, non-specific ones) or there are elevated concentrations of mercury in blood.

ACS 92

ACS Plasma OR ED 92