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

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

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

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 110

EMS Ambulance FFP ICU 110

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

EMDocs

NOVEMBER 20, 2023

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).

Frozen Plasma 99

Frozen Plasma FFP Plasma OR 99

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 104

ALS FFP Plasma Emergency Department 104

Emergency Medicine Cases

FEBRUARY 9, 2021

Once the dust settles, what do we need to tell the patient and/or their family about the consequences of being massively transfused? What should be the lab resuscitation targets? Why is serum calcium important to draw in the ED for the patient who is exsanguinating? How do we mitigate the risk of hypothermia? What's better, 1:1:1 or 2:1:1?

Plasma 130

Plasma ED OR FFP 130

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

Broome Docs

NOVEMBER 17, 2023

This was a huge undertaking, Justin magaged to distill all the data into a talk that covers the science (scant as it may be) and the practical application of the numbers at the bedside (or roadside). Huge thanks to Justin for sharing his wisdom and his dogged dedication to the data!

FFP 130

FFP OR 130

Emergency Medicine Ireland

OCTOBER 28, 2020

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.

Critical Care 40

Critical Care Plasma FFP ICU 40

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

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 94

E-9-1-1 Frozen Plasma Plasma Overdose 94

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 72

ED E-9-1-1 ALS Emergency Department 72