Core EM

JANUARY 25, 2024

Renal injury: isolated proteinuria or hematuria, moderate acute kidney injury with serum creatinine levels <2 mg/dL Skin: petechiae and purpura Despite severe thrombocytopenia, clinically significant bleeding is rare Figure 1.

Plasma 246

Plasma Frozen Plasma Emergency Department FFP 246

The Skeptics' Guide to EM

DECEMBER 17, 2022

The transfusion tech calls to remind you that your protocol is currently under review, and asks if would you like the 1:1 or the 1:3 version of fresh-frozen plasma (FFP) to packed red blood cells (pRBC)? Noting with some relief that at least he isn’t anticoagulated, you activate the hospital massive transfusion protocol. years ( 2 ).

Frozen Plasma 130

Frozen Plasma FFP Emergency Medical Services Plasma 130

Critical Care Scenarios

DECEMBER 13, 2020

Continue to use a balanced ratio unless you can use TEG to guide FFP and platelets.* FFP is delayed or unavailable; 2. Takeaway lessons * In an ideal world, penetrating abdominal trauma in an unstable patient would proceed directly to the OR with no delay by the ED. A positive FAST would reinforce that decision.)*

FFP 100

FFP Critical Care ED OR 100

REBEL EM

OCTOBER 30, 2023

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 128

FFP ALS OR EMS 128

Critical Care Scenarios

DECEMBER 6, 2023

FFP is usually not given prophylactically. . * Livers can now be placed on warm perfusion pumps, allowing continued viability for much longer. This is mainly used in donors who died from cardiac death, those with high BMI or similar risks for primary non-function (i.e. Incision is a large right subcostal incision, extended as needed.

FFP 130

FFP OR 130

Don't Forget the Bubbles

JUNE 30, 2023

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. Ranulf is quite a sweet, round-faced boy, accompanied by his traumatised-looking mother as he is wheeled to your trauma bay.

E-9-1-1 139

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

EMDocs

JUNE 22, 2024

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 111

EMS FFP Ambulance ICU 111

REBEL EM

SEPTEMBER 26, 2022

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

FFP E-9-1-1 ICU ALS 52

ESO

MARCH 15, 2024

The 2023 Trauma Index revisits the metric surrounding whole blood and packed red blood cell (PRBC) transfusions for trauma patients with an Early Blood Transfusion Needs Score (EBTNS) greater than five. Focusing on patients with an EBTNS greater than five allows us to eliminate records where no score was calculated.

Frozen Plasma 111

Frozen Plasma Plasma FFP OR 111

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.”

Frozen Plasma 52

Frozen Plasma FFP ALS Plasma 52

EMDocs

JUNE 12, 2024

FFP and platelets also contain citrate. A meta-analysis found that 56% of patients with severe trauma resulting in hypotension have hypoCa.There was an increase in mortality, increased need for transfusion, and increased risk of coagulopathy in patients with hypoCa. Why is calcium important in trauma or critical illness? mmol/L to 1.3

ALS 106

ALS FFP Plasma Emergency Department 106

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. It is thus imperative that emergency physicians be able to recognize and properly treat this disease, especially in the absence of its classical presentation.

Frozen Plasma 40

Frozen Plasma Plasma Emergency Department FFP 40

Don't Forget the Bubbles

OCTOBER 28, 2024

Major haemorrhage protocols typically include a mixture of packed red blood cells (pRBCs), platelets, and fresh frozen plasma (FFP). Platelets and FFP replace lost platelets and coagulation factors, which help with clotting and also provide some volume expansion. This makes comparing data across research trials challenging.

Frozen Plasma 72

Frozen Plasma FFP Plasma ALS 72

EMDocs

MARCH 18, 2025

Warfarin: vitamin K 10 mg IV and PCC or FFP. Fibrinogen level < 150 mg/dL: cryoprecipitate or fibrinogen concentrate (not FFP). Fibrinogen level < 150 mg/dL: cryoprecipitate or fibrinogen concentrate (not FFP). Prior to current therapies, mortality rates ranged between 50-100%. Imaging: Start with bedside chest x-ray.

E-9-1-1 82

E-9-1-1 FFP Critical Care ALS 82

EMDocs

DECEMBER 6, 2024

Children without vomiting within 6 hours of iron ingestion will almost never have significant toxic effects. 6 Can see subsequent electrolyte disturbances and dehydration related to severity of GI symptoms. In severe toxicity, hematemesis, melena, or hematochezia may occur. Be wary of this stage. This stage does not always occur. 2 L/hr in adults.

E-9-1-1 98

E-9-1-1 Frozen Plasma Plasma Overdose 98

Don't Forget the Bubbles

FEBRUARY 5, 2025

Trauma is the most significant contributor to childhood mortality, with the mechanism changing with maturity and social development. In younger children, the predominant mechanism of inflicted injury is by shaking or beating, and most commonly, the abuser is a family member or caregiver. Do I have emergency blood available in the ED?

E-9-1-1 59

E-9-1-1 CPR Ambulance ED 59

EMDocs

JANUARY 6, 2025

History of Present Illness The collateral history indicates that her symptoms began one week into her journey, but medical care was inaccessible at the time. The family reports no history of food allergies, insect bites, or contact with sick individuals. The patient did not receive pre-travel prophylaxis for malaria, hepatitis A, or yellow fever.

ED 75

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