2017, Blood Transfusions and Outcomes

Are we on the right TRACT?

Don't Forget the Bubbles

JANUARY 10, 2024

Transfusion Decisions in Severe Anaemia Reducing child mortality remains high on the global health agenda. Let’s take the humble blood transfusion – used in emergency departments across the globe and playing a key role in critical care. However, there is a huge variation in transfusion practice globally.

Blood Transfusions

Blood Transfusions Outcomes Research Hospitals

NFTI And STAT: Can They Replace The Cribari Grid?

The Trauma Pro

MAY 10, 2024

And its correlation with outcomes varies. J Trauma Nursing 24(3):150-157, 2017. The most important one is that it relies only on the Injury Severity Score (ISS) to judge whether some type of mistriage occurred. The ISS is usually calculated after discharge, so it can only be applied after the fact. What is NFTI, Exactly?

Blood Transfusions

Blood Transfusions Documentation/Coding Radiology Radiology

emDOCs Revamp – Acute Chest Syndrome

EMDocs

JUNE 27, 2024

His medical history is significant for three prior admissions for vaso-occlusive crises that have responded well to appropriate therapy, including pain control with NSAIDs and opioids, blood transfusions, antibiotics, and intravenous (IV) crystalloids. 2017 Dec 1;30(4):191-201. Pediatr Blood Cancer. Am J Emerg Med.

Pediatrics

Pediatrics Dehydration EMS Hospitals

A Beginner’s Guide to Vasoactive Drug use in Children with Septic Shock

Don't Forget the Bubbles

NOVEMBER 27, 2023

Either is reasonable as first-line, and there are not currently any studies which directly compare outcomes against each other for children with septic shock. The citrate in blood products can also bind to calcium and cause a drop in calcium levels, so do anticipate this for any children requiring blood transfusion.

Shock

Shock Sepsis Fluid Resuscitation Resuscitation

Subarachnoid hemorrhage: ED presentation, evaluation, and management

EMDocs

JULY 3, 2023

Introduction SAH has the potential for rapid progression and devastating outcomes. Hematoma expansion Reducing blood pressure to a level that limits bleeding but maintains perfusion is critical to limit hematoma expansion, especially in spontaneous SAH. Short- and long-term outcome of patients with aneurysmal subarachnoid hemorrhage.

Seizures

Seizures Stroke Outcomes EMS

Journal Club - Tranexamic Acid in Trauma

Downeast Emergency Medicine

APRIL 26, 2021

4] We also know that severe TBI is commonly associated with the development of intracranial hemorrhage where the presence and volume of blood are associated with increased mortality and poor outcomes.[5] Association between prehospital tranexamic acid administration and outcomes of severe traumatic brain injury. JAMA Neurol.

Head Injuries

Head Injuries Administration Outcomes Seizures

Trauma Resuscitation Updates

RebelEM

MAY 25, 2023

Ann Emerg Med 2017 [6] This was a retrospective database review of 7521 traumatic brain injury patients SBP target ≥90mmHg resulted in a mortality of 7.8% vs SBP target <90mmHg which resulted in a mortality of 33.4% NEJM 1994. [2]

Resuscitation

Resuscitation Fluid Resuscitation Head Injuries Shock

Restrictive or Liberal Transfusion Strategy in Myocardial Infarction and Anemia (MINT Trial)

RebelEM

FEBRUARY 22, 2024

Background : Concurrent anemia worsens outcomes in patients that present with acute myocardial infarctions. Transfusions increase the oxygen carrying capacity of blood which can improve the perfusion of at-risk cardiac tissue. An optimal transfusion hemoglobin cutoff has not yet been established in these patients.

Blood Transfusions

Blood Transfusions Outcomes Wellness Research

emDOCs Podcast – Episode 102: Hypocalcemia in Trauma and the Diamond of Death

EMDocs

JUNE 12, 2024

HypoCa is common in trauma patients and is associated with poor outcomes. A meta-analysis found that 56% of patients with severe trauma resulting in hypotension have hypoCa.There was an increase in mortality, increased need for transfusion, and increased risk of coagulopathy in patients with hypoCa. J Trauma Acute Care Surg.

Hyperthermia / Hypothermia

Hyperthermia / Hypothermia Resuscitation Administration Blood Transfusions

TEG-Guided Resuscitation of Patients with Cirrhosis and Non-Variceal Bleeding

RebelEM

SEPTEMBER 26, 2022

A meta-analysis of fifteen RCTs comparing blood product transfusion rates of cardiothoracic and surgery patients found significantly lower transfusion rates of FFP in TEG/ROTEM guided group compared to traditional tests, with no difference in survival rates (Fahrendorff 2017). Article: Kumar M et al.

Resuscitation

Resuscitation Blood Transfusions Outcomes Hospitals

Sickle Cell Disease Module

Don't Forget the Bubbles

JULY 5, 2023

Furthermore, educating both patients and their families is important in order to achieve good treatment compliance and better clinical outcomes. 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.

Blood Transfusions

Blood Transfusions Stroke Dehydration Sepsis

Vasopressor Nonresponse

Northwestern EM Blog

JANUARY 24, 2022

Those at higher risk of hypocalcemia (vitamin D deficiency, ESRD, hyperparathyroidism, burns, multiple blood transfusions, etc.) However, even subclinical hypothyroidism with an elevated TSH but normal T4 increases risk of poor outcomes due to effects on cardiac function. 2017; 45(9): 1443-1449. Intensive Care Medicine.

Anaphylaxis

Anaphylaxis Shock Sepsis Resuscitation

Unstable Pelvic Trauma Patient: ED Presentations, Evaluation, and Management

EMDocs

JUNE 3, 2023

For a broader overview of pelvic trauma, please review Dr. Lupez’s 2017 article here: [link]. Published 2017 Jan 18. Management and outcomes of open pelvic fractures: An update. Published 2017 Oct 12. BJJ-2017-0852.R1 2 Vertical shear fractures are also unstable. link] Published June 23, 2015. World J Emerg Surg.

Fractures

Fractures Resuscitation Operations EMS

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

The Skeptics' Guide to EM

DECEMBER 17, 2022

Massive Blood Transfusion Following Older Adult Trauma: the Effect of Blood Ratios on Mortality. Case: A […] The post SGEM386: Blood on Blood – Massive Transfusion Protocols in Older Trauma Patients first appeared on The Skeptics Guide to Emergency Medicine. Date: December 16th, 2022 Reference: Hohle et al.

Blood Transfusions

Blood Transfusions Fractures EMS Hospitals

Episode 21- Updates and Controversies in the Early Management of Sepsis and Septic Shock

EB Medicine

OCTOBER 1, 2018

In other trials, vasopressin also appeared to show a potential benefit in those with AKI and sepsis, although the subsequent VANISH trial (perhaps the best name for a clinical trial so far) failed to demonstrate a benefit to vasopressin titration with regard to renal outcomes in septic shock. Jeff : Next we have epinephrine.

Sepsis

Sepsis Shock Fluid Resuscitation Hospitals

Emergency Care Today

Are we on the right TRACT?

NFTI And STAT: Can They Replace The Cribari Grid?

Trending Sources

emDOCs Revamp – Acute Chest Syndrome

A Beginner’s Guide to Vasoactive Drug use in Children with Septic Shock

Subarachnoid hemorrhage: ED presentation, evaluation, and management

Journal Club - Tranexamic Acid in Trauma

Trauma Resuscitation Updates

Restrictive or Liberal Transfusion Strategy in Myocardial Infarction and Anemia (MINT Trial)

emDOCs Podcast – Episode 102: Hypocalcemia in Trauma and the Diamond of Death

TEG-Guided Resuscitation of Patients with Cirrhosis and Non-Variceal Bleeding

Sickle Cell Disease Module

Vasopressor Nonresponse

Unstable Pelvic Trauma Patient: ED Presentations, Evaluation, and Management

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

Episode 21- Updates and Controversies in the Early Management of Sepsis and Septic Shock

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