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Trauma Resuscitation Updates

RebelEM

vs 3U) but no difference in mortality (Study not powered for this outcome) Clinical Take Home Point: The use of vasopressors is controversial and requires a nuanced approach SUMMARY OF MINIMIZING IATROGENIC INJURY RESTORE PERFUSION VOLUME REPLACEMENT Blood Products >>> Crystalloids Holcomb JB et al. 2010; 376(9734):23-32.

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Rethinking the Role of TXA: Are We Asking Too Much?

RebelEM

PMID: 37314244 Clinical Question: In advanced trauma systems, does prehospital administration of TXA increase the rate of survival with a favorable neurologic outcome in patients at risk for trauma-induced coagulopathy? Lancet 2010; 376(9734): 23-32. Article: PATCH-Trauma Investigators and ANZICS Clinical Trial Group.

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Vasopressor Nonresponse

Northwestern EM Blog

At those levels, bicarbonate administration has not been shown to improve cardiac output, MAP or pressor response. For example, a patient in cardiogenic shock will likely worsen with the administration of fluids and the wrong vasopressors. 2010; 36: 2019-2029. Alternate Shock Not all shock is declared equal. 2007; 25: 309-331.

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Journal Club - Tranexamic Acid in Trauma

Downeast Emergency Medicine

2][3] If earlier treatment with TXA is better, would there be benefit in its administration in the prehospital setting? Association between prehospital tranexamic acid administration and outcomes of severe traumatic brain injury. Blood Coagul Fibrinolysis. If so, could this be done safely? JAMA Neurol. 2021;78(3):338–345.

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Sickle Cell Disease Module

Don't Forget the Bubbles

Be careful if the patient has received a recent blood transfusion since it may be misinterpreted as sickle cell trait instead of sickle cell disease. In these cases, repeat the Hb electrophoresis three months after the last blood transfusion. Would you consider this patient for blood transfusion?