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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. The last theme focuses on the issues with decision-making itself.

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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. NEJM 1994. [2]

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Sickle Cell Disease Module

Don't Forget the Bubbles

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.

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

RebelEM

Randomized study design Blind adjudication of transfusion reaction outcomes Follow-up was complete. The primary outcome was disease-oriented The enrolled cohort appears to be a convenience sample Sealed envelopes are a weak type of allocation and prone to error and manipulation. Hayes-Larson 2019).

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ToxCard: Iron

EMDocs

7 Workup other than serum iron concentration at 4 hours after ingestion not shown to accurately predict clinical outcomes or severity of toxicity. Blood transfusion for clinically significant blood loss. McGraw Hill; 2019. 6 Absence of visualized tablets on x-ray does not exclude iron ingestion. 2 L/hr in adults.

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emDOCs Revamp – Acute Chest Syndrome

EMDocs

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. 2019 Jan 24;14:263-292. Pediatr Blood Cancer. 2020 Feb 12;10(1):2470.

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Journal Club - Tranexamic Acid in Trauma

Downeast Emergency Medicine

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] Lancet 2019; Vol 394, Iss 10210, P 1713-1723[ Full Text ]. There were no differences found in the secondary outcomes.