Core EM

OCTOBER 16, 2024

Author: Natalie Bertrand, MD Editor: Naillid Felipe, MD Background: Definition: adverse reaction to blood product administration Incidence: more common in children than adults, except for delayed hemolytic transfusion reactions Allergic (non-anaphylaxis) – Platelets 1-3%; RBCs 0.1-0.3% mg IF requiring IM Epi >3x, switch to IV Epi, 0.05-0.1

Allergic Reaction 145

Allergic Reaction Plasma ED Epinephrine 145

Emergency Medicine Ireland

JUNE 7, 2021

In the plasma itself, 50% is ionised, 40% is plasma bound and 10% is chelated to various anions. There is a large gradient between the ionised calcium in the plasma and the tiny ionised fraction in the cells. Now let’s turn to hypercalcaemia, a fairly common diagnostic issue in the ICU.

Critical Care 52

Critical Care Plasma ICU OR 52

EMDocs

APRIL 10, 2024

Metabolism of ester anesthetics is by plasma cholinesterase, whereas amides are metabolized by the cytochrome P450 system in the liver. [6] 6] Action of local anesthetics is dependent upon the molecule crossing the plasma membrane in a unionized form. [2] 2] This linking group can be either an amide (e.g., lidocaine) or an ester (e.g.,

E-9-1-1 93

E-9-1-1 Plasma Epinephrine Life Support 93

Critical Care Scenarios

OCTOBER 31, 2021

Plasma free hemoglobin levels may be a useful marker that changing your oxygenator could improve gas exchange.* Decannulate at the bedside when ready, watch them for 24 hours, then boot them out of the ICU; they’re ready.* In such cases, beta blockade may actually improve systemic oxygenation.*

Interfacility Transport 100

Interfacility Transport Plasma ICU EMS 100

Critical Care Scenarios

JANUARY 10, 2021

.* Treat initially with steroids per the RECOVERY trial (dexamethasone 6 mg daily for 10 days); then, if needing ICU or especially if needing intubation, consider the DEXA-ARDS protocol (20 mg daily for 5 days, then 10 mg daily for another 5 days).

Critical Care 100

Critical Care Plasma ICU OR 100

Emergency Medicine Ireland

OCTOBER 28, 2020

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

Critical Care 40

Critical Care Plasma FFP ICU 40

Core EM

OCTOBER 2, 2024

Author: Natalie Bertrand, MD Editor: Naillid Felipe, MD Background: Definition: adverse reaction to blood product administration Incidence: more common in children than adults, except for delayed hemolytic transfusion reactions Allergic (non-anaphylaxis) – Platelets 1-3%; RBCs 0.1-0.3% mg IF requiring IM Epi >3x, switch to IV Epi, 0.05-0.1

Allergic Reaction 100

Allergic Reaction Plasma ED Epinephrine 100

Emergency Medicine Ireland

MARCH 4, 2021

GBS is a clinically important diagnosis for both the emergency department and the ICU. GBS is a clinically important diagnosis for both the emergency department and the ICU. In the ICU the diagnosis is usually fairly easy as they come with a label of possible GBS in the referral. Its rareish but common enough that you.

Critical Care 40

Critical Care ICU Plasma Emergency Department 40

Don't Forget the Bubbles

JUNE 30, 2023

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. Pragmatic Randomized Optimal Platelet and Plasma Ratios (PROPPR) Trial: design, rationale and implementation. in 1:1:2 group; difference, −5.4% [95% CI, −10.4% to −0.5%]; P  = 0.03.).

E-9-1-1 139

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

Pediatric EM Morsels

MARCH 17, 2023

(Judge 2019) Best when given within 4 hours of the bite, but still effective within 24 hours Always give an entire vial of antivenom, never a partial vial. It’s expensive, so if you’re giving some of a vial, give it all.

Frozen Plasma 130

Frozen Plasma Plasma First Aid OR 130

AAEM RSA

APRIL 1, 2021

2,3 Here we examine some of the evidence behind the various components of MTPs, specifically calcium and factor VIIa, and the ratios in which the main products of red blood cells, plasma, and platelets should be administered. What is the ideal blood component ratio for massive transfusion in traumatic hemorrhage? vs. 78.1%, p=0.006).

E-9-1-1 52

E-9-1-1 Plasma ACS ALS 52

REBEL EM

JUNE 26, 2023

Reversal of Trauma-Induced Coagulopathy Using First-Line Coagulation Factor Concentrates or Fresh Frozen Plasma (RETIC): A Single-Centre Parallel-Group, Open-Label Randomised Trial. Severe acute traumatic coagulopathy = PT >1.5 to 3.33; P = 0.72 to 2.10; P = 0.03 PMID: 36942533 Innerhofer P et al. Lancet Haematol 2017.

FFP 145

FFP Frozen Plasma ALS Plasma 145

Don't Forget the Bubbles

NOVEMBER 15, 2023

Have a look to see how their osmolarity and tonicity across the cell membrane compare to plasma. Renal (= urine output) : anti-diuretic hormone (ADH) release from the posterior pituitary is stimulated by microchanges in plasma osmolarity. What loss mechanisms do we need to consider? Intensive Care Med. 2018;44(4):409-417.

Plasma 80

Plasma ALS ICU Critical Care 80

EMDocs

JUNE 7, 2023

8 Plasma butyrylcholinesterase (“pseudocholinesterase”) activity Easier to assay and is more widely available Red cell acetylcholinesterase (“true cholinesterase”) activity More accurate and specific Management: Patients require immediate intervention if there is concern for acute organophosphate poisoning.

E-9-1-1 83

E-9-1-1 ICU Emergency Department ED 83

Emergency Medicine Ireland

OCTOBER 17, 2022

We talk a lot about cerebral protective measures in the ICU and hopefully this will give you a little of the basic physiological background. The brain apparently receives 15% of the cardiac output, though I imagine by the end of a typical ICU on call shift, that proportion will have dropped quite significantly.

Critical Care 40

Critical Care ICU Plasma OR 40

Don't Forget the Bubbles

JULY 5, 2023

SCD, therefore, is not only a mechanical disease but there are also many other cellular and plasma factors as well as endothelial interaction that generate chronic inflammation. They should be admitted to hospital in case of clinical deterioration to receive ICU treatment. This treatment is usually done in the ICU setting.

E-9-1-1 126

E-9-1-1 ACS OR ICU 126

Dr. Smith's ECG Blog

APRIL 6, 2018

Terbutaline and Albuterol for Lowering of Plasma Postassium Initial labs returned and confirmed critical hyperkalemia and new renal failure. He made it to the ICU, however the patient unfortunately expired approximately 24 hours after ICU admission. We should also have given 0.25mg intramuscular terbutaline, but we did not.

Defibrillator 52

Defibrillator ICU EMS Plasma 52

EMDocs

DECEMBER 18, 2023

The first was the suggestion to use balanced crystalloid fluids, such as lactated ringers or plasma-lyte, instead of normal saline. Disposition The SSC guidelines suggest that patients with septic shock or critical illness be moved to the intensive care unit (ICU) within six hours of presentation to the ED. 2020;157(2):286-292.

E-9-1-1 65

E-9-1-1 ALS Emergency Department Plasma 65