Remove FFP Remove OR Remove Plasma
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Anticoagulation Reversal

Core EM

Background Around 6 million people in the U.S. 2017 ACC Expert Consensus Decision Pathway on Management of Bleeding in Patients on Oral Anticoagulants: A Report of the American College of Cardiology Task Force on Expert Consensus Decision Pathways. Background Around 6 million people in the U.S. Background Around 6 million people in the U.S.

FFP 130
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Thrombotic Thrombocytopenic Purpura (TTP)

Core EM

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
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Data Café Insights: Whole Blood and PRBC Usage

ESO

Balance resuscitation strategy, often in a 1:1:1 ratio of PRBCs with fresh frozen plasma and platelets. 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.

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Ep 152 The 7 Ts of Massive Hemorrhage Protocols

Emergency Medicine Cases

Until the results of lab testing come back and hemorrhage pace is slowed, what ratio of plasma to RBCs should we target? 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? How do we mitigate the risk of hypothermia?

Plasma 130
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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

Treatment consists of: * PLEX – actual proper PLEX with plasma replacement as opposed to just washing out all the good stuff and giving albumin as replacement. The plasma replacement replaces factors and reduces the bleeding risk (which is already high) but also acts as a source of ADAMSTS13.