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

REBEL EM

Severe acute traumatic coagulopathy = PT >1.5 to 3.33; P = 0.72 NOT STATISTICALLY SIGNIFICANT Also no difference in individual components given Thromboembolic Events: 4F-PCC: 35% Placebo: 24% Absolute Diff: 11%; 95% CI 1 to 21% Relative Risk 1.48; 95% CI 1.04 to 2.10; P = 0.03 Severe acute traumatic coagulopathy = PT >1.5 to 3.33; P = 0.72

FFP 145
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TEG-Guided Resuscitation of Patients with Cirrhosis and Non-Variceal Bleeding

REBEL EM

A meta-analysis of fifteen RCTs comparing blood product transfusion rates of cardiothoracic and surgery patients found significantly lower transfusion rates of FFP in TEG/ROTEM guided group compared to traditional tests, with no difference in survival rates (Fahrendorff 2017). Significant coagulopathy: INR > 1.8

FFP 52
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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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Penetrating chest trauma

Don't Forget the Bubbles

They found NO difference in drain failure rates ( 11% pigtail vs 13% chest tube P=0.74), total daily volume drained or length of ICU stay between groups. You ask your anaesthetist to get ready to sedate or intubate depending on their status – Significant risk to the department – you make sure security is aware And your patient arrives.

E-9-1-1 139
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Tasty Morsels of Critical Care 001 | Thrombotic Thrombocytopaenic Purpura

Emergency Medicine Ireland

TTP is a lovely ICU diagnosis. TTP is a lovely ICU diagnosis. 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. Welcome back to the tasty morsels of critical care podcast.