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CRYOSTAT-2: Early Empiric Cryoprecipitate in Major Trauma

REBEL EM

Most major hemorrhage protocols give a balanced transfusion of PRBCs, FFP, and platelets in ratios approaching concentrations found in whole blood. Fibrinogen and fibrin are often depleted during major trauma as a result of consumption, breakdown, and dilution. Fibrinogen products may also be needed to stabilize clots and stem bleeding.

FFP 127
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EM@3AM: Amniotic Fluid Embolism

EMDocs

A) Amniotic fluid embolism B) Eclampsia C) Placental abruption D) Pulmonary embolism Answer: A Amniotic fluid embolism (AFE) is a rare but potentially fatal complication of pregnancy. AFE should be considered in a patient who experiences cardiorespiratory collapse during labor or shortly thereafter.

EMS 96
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Best Practices for Upper Gastrointestinal Hemorrhage

ACEP Now

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.”

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Guideline Update: Acute Lower GI Bleeding

EMDocs

For patients on VKAs to prevent stroke in nonvalvular atrial fibrillation who require reversal, 4-factor prothrombin complex concentrate (PCC) is preferred to fresh frozen plasma (FFP) because of the rapidity of INR reduction (Conditional recommendation, very low-quality evidence). Conditional recommendation, low-quality evidence).

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Tasty Morsels of Critical Care 001 | Thrombotic Thrombocytopaenic Purpura

Emergency Medicine Ireland

Theoretically giving them FFP while waiting on PLEX seems like it might be sensible but in reality probably does nothing when the autoantibodies are still around. In normal circumstances ADAMSTS13 is there to stop your platelets and your vWF getting two cosy in these things called multimers.

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REBEL Cast Ep 118: The PROCOAG Trial – 4F-PCC for Trauma Patients?

REBEL EM

This could potentially help improve thrombin generation, reduce blood product consumption, but also could increase the risk of thromboembolic events. Some clinicians have advocated for early administration of 4-factor prothrombin complex concentrate (4F-PCC) based on limited observational data. to 3.33; P = 0.72 to 2.10; P = 0.03

FFP 145
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REBEL Core Cast 108.0 – Angioedema

REBEL EM

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 ). Typically involves the mouth, larynx, pharynx, and subglottic tissue ( Kostis 2005 ).