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Podcast 185.0: Anticoagulation Reversal

Core EM

Comparison between Prothrombin Complex Concentrate (PCC) and Fresh Frozen Plasma (FFP) for the Urgent Reversal of Warfarin in Patients with Mechanical Heart Valves in a Tertiary Care Cardiac Center. Iran J Pharm Res. 2015;14(3):877-885. Fariborz Farsad B, Golpira R, Najafi H, et al.

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Data Café Insights: Whole Blood and PRBC Usage

ESO

They received fewer PRBCs, fresh frozen plasma (FFP), and platelets across their LOS, while total units and volumes were similar. Balance resuscitation strategy, often in a 1:1:1 ratio of PRBCs with fresh frozen plasma and platelets.

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SGEM386: Blood on Blood – Massive Transfusion Protocols in Older Trauma Patients

The Skeptics' Guide to EM

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.

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REBEL Core Cast 108.0 – Angioedema

REBEL EM

Fresh frozen plasma for progressive and refractory angiotensin-converting enzyme inhibitor-induced angioedema. Read More EMCrit: Podcast 145 – Awake Intubation Lecture from SMACC ERCast: Angioedema References: Baş M et al. A randomized trial of icatibant in ACE-inhibitor-induced angioedema. N Engl J Med. 2015; 372(5):418-25.

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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.

FFP 130
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Thrombotic Thrombocytopenic Purpura (TTP)

Core EM

Joly, 2017; Sawler, 2020) Fresh frozen plasma (FFP) (contains ADMTS-13) may be used to supplement ADAMTS-13 if there is a delay in initiating TPE in the emergency department (i.e. The first TPE session should be completed prior to administration of any biologic therapies. if the patient is being transferred to another hospital).

Plasma 246
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SGEM#251: Nothing Compares to You…Because there was No Comparison Group

The Skeptics' Guide to EM

In contrast, protamine could be used for heparin and LMWH reversal and vitamin K, fresh frozen plasma and prothrombinase complex concentrate could be used to reverse coumadin ( Hunt and Levi BMJ 2018 ). This changed in 2015 when the Food and Drug Administration (FDA) approved idarucizumab for the reversal of dabigatran.