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Imported Malaria

Pediatric EM Morsels

2019; 17: 98. 2019; 47(2): 183–193. PMID: 27186577 Conroy AL, Opoka RO, Bangirana P, Idro R, Ssenkusu JM, Datta D, Hodges JS, Morgan C, John CC. Acute kidney injury is associated with impaired cognition and chronic kidney disease in a prospective cohort of children with severe malaria. Pediatr Clin N Am 69 (2022) 47–64. 8 Dec 2022.

Seizures 281
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Understanding pre-hospital blood transfusion decision-making for injured patients: an interview study

Emergency Medicine Journal

Background Blood transfusion for bleeding trauma patients is a promising pre-hospital intervention with potential to improve outcomes. However, it is not yet clear which patients may benefit from pre-hospital transfusions. Interviews were semi-structured and explored how decisions were made and what made decisions difficult.

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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. Lancet 2019.

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MTP Activation Criteria For Pediatric Patients

The Trauma Pro

Reference: The ABC-D score improves the sensitivity in predicting need for massive transfusion in pediatric trauma patients. Epub 2019 Nov 1. Several adult and pediatric trauma centers in the Denver area collaborated to test a new score using the ABC-S score in combination with serum lactate and base deficit. J Pediatr Surg.

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ToxCard: Iron

EMDocs

Blood transfusion for clinically significant blood loss. 5 Consider exchange transfusion in addition to deferoxamine for serum iron concentrations greater than 1000 g/dL, or those who clinically deteriorate despite supportive care and chelation. McGraw Hill; 2019. References: Perrone J. Tenenbein M. 159.6.557.

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The AcT Trial: Tenecteplase vs Alteplase for Acute Ischemic Stroke

RebelEM

What they Did : Investigator-initiated, Multicenter, Parallel-ground, Open-label, Registry-linked, Randomized, Controlled, Non-Inferiority trial 22 Canadian Primary and Comprehensive Stroke Centers from December 2019 to January 2022 Eligible ischemic stroke patients randomized 1:1 to receive intravenous tenecteplase (0.25 vs Alteplase 34.8%

Stroke 135
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The Latest in Critical Care, 1/8/23 (Issue #24)

PulmCCM

million gallons) of blood are wasted in this fashion, every year—enough to fill about 700 railroad tanker cars with blood, or about four times the total amount of blood transfused annually. Smaller-volume blood collection tubes are widely available at equivalent cost and are compatible with standard blood analyzers.