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Annals of B Pod: Anti-Xa Overdose

Taming the SRU

Given her intracranial hemorrhages, significant attempts were made to improve coagulation including administration of IV vitamin K, 3 units of fresh frozen plasma, and administration of four-factor prothrombin complex concentrate (PCC, Kcentra). However, crucially, this assay must be calibrated to the agent of interest. [8]

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REBEL Core Cast 98.0 – AVNRT

RebelEM

An alternate administration approach can be found on ALiEM. 2010, (Ch) 79: p 1034-63. Verapamil (Non-dihydropyridine Calcium Channel Blocker) Class IV antidysrhythmic agent that slow Ca 2+ channels and thus, slow conduction at the AV node and suppresses the SA node. Louis, Mosby, Inc.,

EKG/ECG 52
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Episode 31 - Emergency Department Management of Patients Taking Direct Oral Anticoagulant Agents (Pharmacology CME)

EB Medicine

Nachi: Specifically, we’ll be focusing on the use of DOACs for the indications of stroke prevention in atrial fibrillation and the treatment and prevention of recurrent venous thromboembolisms. Nachi: However, in 2010, the FDA approved the first DOAC, a real game-changer.

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52 in 52 – #38: Thrombolysis Guided by Perfusion Imaging up to 9 Hours after Onset of Stroke

EMDocs

This week we cover the EXTEND trial looking at thrombolysis up to 9 hours after stroke onset. and 9 hours after onset of symptoms, with non-infarcted brain tissue, does the administration of alteplase improve functional outcome at 90 days? Intervention: Alteplase 0.9 in alteplase group versus 0.9% to 53.54, p=0.053).

Stroke 98
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REBEL Cast Ep123: Reduced-Dose Systemic Peripheral Alteplase in Massive PE?

RebelEM

PMID: 37188358 Clinical Question: What is the efficacy and safety of low-dose (25mg) prolonged administration (over 6hrs) of alteplase in patients with massive PE? Reduced-Dose Systemic Fibrinolysis in Massive Pulmonary Embolism: A Pilot Study. Clin Exp Emerg Med 2023. in the paper but 2.7% to ≈0.99 (p<0.001) Mean MPI/Tei Index≈ 0.47

Stroke 136
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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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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. MI or stroke). If so, could this be done safely? JAMA Neurol. 2021;78(3):338–345.