RebelEM
MAY 25, 2023
JAMA 2015 [7] The PROPPR Trial 680 severely injured adult trauma patients Patients randomized to Plasma, Platelets, and PRBCs in a 1:1:1 ratio vs 1:1:2 ratio No difference in overall mortality at 24 hrs BUT 1:1:1 achieved hemostasis faster and fewer experienced death due to exsanguination at 24hrs Crombie N et al. Intensive Care Med 2020. [13]
RebelEM
APRIL 29, 2024
In these situations, the American Heart Association (AHA) and the European Resuscitation Council (ERC) of 2015 recommend the intraosseous (IO) route after the peripheral route and before the central venous route ( 1). In cardiac arrest, a delay in IV access subsequently results in a delay in epinephrine administration. Crit Care Med.
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EMDocs
JUNE 12, 2024
Two randomized controlled trials by Moore et al found that prehospital plasma administration in trauma patients is associated with hypoCa (53% vs 36%). Prehospital Ca administration reduces risk of hypoCa on arrival (70% vs. 28%). Make Ca administration a part of your massive transfusion protocol. Anaesth Intensive Care.
EMDocs
MARCH 18, 2025
TXA administration should not delay other interventions. 2015 Mar;45(3):756-64. TXA is cheap and likely safe. Dosing: 500-1000 mg nebulized, followed by 500 mg every 8 hours. If cannot tolerate a nebulizer or clear secretions, administer TXA 1-2 g IV. What are other key parts of management? Respiration. 2012;83(2):106-14. Eur Respir J.
EMDocs
MAY 25, 2023
mg/kg or 10 mg Seizures must persist for at least 5 minutes after administration of the prespecified benzodiazepines. In light of these data, I will give levetiracetam due to its less severe side effects and ease of administration. mg/kg or 10 mg Intravenous lorazepam 0.1 mg/kg or 4 mg Intravenous midazolam 0.2
RebelEM
JANUARY 9, 2024
Additionally, multiple studies demonstrate increased harm with IV antibiotics such as increased rate of diarrhea ( Haran 2014 ), complications from IV placement ( Li 2015 ), and increased length of stay or cost ( Lorgelly 2010 ). Oral administration of antibiotics: a rational alternative to the parenteral route. 2015; 12(5):e1001825.
The Skeptics' Guide to EM
MAY 21, 2017
His prehospital vital signs were oxygen saturation of 89% and respiratory rate of six breaths per minute prior to administration of oxygen and 1 mg of naloxone. After naloxone administration he is alert and oriented times three with a normal pulse oximetry and clear lung fields. There were two new recommendations.
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