2020 and Blood Transfusions - Emergency Care Today

There will be blood

Intensive Blog

AUGUST 17, 2023

What is an appropriate “trigger threshold” for blood transfusion in ECMO patients? Show answer Commonly, clinicians use a trigger of 80g/L (Tenure et al, 2020). Epub 2020 Sep 10. Epub 2020 Sep 10. Alfred Health (2020, April 18). Cannula site bleeding. What is your action now? doi: 10.1053/j.jvca.2020.08.068.

Blood Transfusions

Blood Transfusions Operations Wellness

Trick of Trade: Dual Foley catheter to control massive epistaxis

ALiEM

MAY 29, 2023

Because he presumably had uremia-induced thrombasthenia (weak platelets), he received blood transfusions and IV TXA. We thus removed the anterior packing and instead inserted a Foley catheter into the posterior nasal space and inflated the balloon. Unfortunately, the bleeding still continued. Interested in Other Tricks of the Trade?

Blood Transfusions

Blood Transfusions Emergency Department Shock Hospitals

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

emDOCs Podcast – Episode 100: Acute Chest Syndrome Part 1

EMDocs

MAY 15, 2024

Management includes rapid initiation of opioid and non-opioid agents to treat the pain associated with vaso-occlusive crisis, antimicrobial coverage, incentive spirometry, oxygen supplementation to maintain saturation > 95%, fluid resuscitation based on volume status, consideration for transfusion, and specialist consultation.

Blood Transfusions

Blood Transfusions Fluid Resuscitation Dehydration Ultrasounds

emDOCs Podcast – Episode 101: Acute Chest Syndrome Part 2

EMDocs

MAY 28, 2024

Blood transfusion Reduces the overall proportion of HbS. Simple blood transfusion should be considered early in the hypoxemic patient with advancement to red cell exchange transfusion if there are clinical features of severe pathology or evidence of progression despite initial simple transfusion.

Blood Transfusions

Blood Transfusions Fluid Resuscitation Dehydration Ultrasounds

The Latest in Critical Care, 11/6/23 (Issue #19)

PulmCCM

NOVEMBER 6, 2023

The therapy was approved for emergency use in 2020 by FDA after an observational study of 10 patients showed likely benefit (yes, 10, which should remind us of our collective desperation). patients infected with the Wuhan/Delta variants in 2020-2021).

Blood Transfusions

Blood Transfusions Operations Resuscitation Infectious Diseases

Massive Transfusion for Motorcycle Collision with Hemorrhage, Troponin Elevated.

Dr. Smith's ECG Blog

JULY 3, 2020

It presents on the ECG as a long ST segment with resultant long QT == MY Comment by K EN G RAUER, MD ( 7/3/2020 ): == The patient in today’s case is a middle-aged woman who was brought to the ED following a motor vehicle accident. The patient was in shock on arrival in the ED — and multiple blood transfusions were needed.

Blood Transfusions

Blood Transfusions EKG/ECG Shock Fractures

Bubble Wrap PLUS – January 2024

Don't Forget the Bubbles

JANUARY 1, 2024

During the COVID-19 pandemic (2020-2021), the incidence of IPD reached its lowest level in 20 years. Hemoglobin Threshold for Blood Transfusion in Young Children Hospitalized with Iron Deficiency Anemia. High Cardiac Troponin Levels in Infants with Acute SARS-CoV-2 Infection: A Prospective Comparative study. Lo Vecchio A, et al.J

Pediatrics

Pediatrics Ultrasounds Blood Transfusions Sepsis

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

Don't Forget the Bubbles

NOVEMBER 27, 2023

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 and sepsis itself can cause low calcium levels due to intracellular shifts and lactate-binding calcium. 2021;25(1):146. Published 2021 Apr 16. link] Roland D.

Shock

Shock Sepsis Fluid Resuscitation Resuscitation

Is there Wenckebach? An Elderly Patient with a Fall

Dr. Smith's ECG Blog

SEPTEMBER 9, 2020

== MY Arrhythmia Case by K EN G RAUER, MD ( 9/9/2020 ): == PREFACE: Recognition of the presence ( or absence ) of AV block is a common problem in emergency medicine. I’ve previously reviewed my S ystematic A pproach to rhythm interpretation ( See especially the August 17, 2020 post). SEE My Comment in the August 17, 2020 post.

EKG/ECG

EKG/ECG Blood Transfusions Operations Hospitals

Subarachnoid hemorrhage: ED presentation, evaluation, and management

EMDocs

JULY 3, 2023

22 Hypertonic saline (HTS) has been shown to improve cerebral blood flow (CBF) and is recommended for ICP reduction in the most recent ASA guidelines. 12 A 2020 neurocritical care review of cerebral edema management recommends the use of HTS in SAH patients without specific sodium level goals, simply recommending symptom-based bolus dosing.

Seizures

Seizures Stroke Outcomes EMS

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. 2020 Feb 12;10(1):2470. F temporal, RR 25, SpO2 89% on room air.

Pediatrics

Pediatrics Dehydration EMS Hospitals

Imported Malaria

Pediatric EM Morsels

NOVEMBER 3, 2023

falciparum accounts for >70% of cases of imported malaria , primarily seen in those returning from travel in Sub-Saharan Africa (Mischlinger 2020) Other species include P. 2020 Mar 11;33(2):e00104-19. vivax , P. malariae , and the less common P. knowlesi and P. simium (Forgie 2022) P. vivax and P. vivax , P. knowlesi and P.

Seizures

Seizures Pediatrics CDC Infectious Diseases

MTP Activation Criteria For Pediatric Patients

The Trauma Pro

JUNE 18, 2024

You can always send the blood back if you don’t need it! Reference: The ABC-D score improves the sensitivity in predicting need for massive transfusion in pediatric trauma patients. 2020 Feb;55(2):331-334. This was termed the ABC-D score. J Pediatr Surg. doi: 10.1016/j.jpedsurg.2019.10.008. 2019.10.008. Epub 2019 Nov 1.

Pediatrics

Pediatrics Blood Transfusions Resuscitation Shock

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

RebelEM

FEBRUARY 22, 2024

2012;126(16):2020-2035. in liberal) received a blood transfusion (2.3 Liberal versus restrictive transfusion thresholds for patients with symptomatic coronary artery disease. Third universal definition of myocardial infarction. Circulation. years Female sex 44.3 Baseline hemoglobin 8.6 Prior heart failure 30.1 Am Heart J.

Blood Transfusions

Blood Transfusions Outcomes Wellness Research

Trauma Resuscitation Updates

RebelEM

MAY 25, 2023

Intensive Care Med 2020. [13] The Role of Whole Blood Transfusions in Civilian Trauma: A Review of Literature in Military and Civilian Trauma. Effects of tranexamic acid on death, vascular occlusive events, and blood transfusion in trauma patients with significant haemorrhage (CRASH-2): a randomised, placebo-controlled trial.

Resuscitation

Resuscitation Fluid Resuscitation Head Injuries Shock

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

EMDocs

JUNE 12, 2024

A review of transfusion- And trauma-induced hypocalcemia: Is it time to change the lethal triad to the lethal diamond? Concentration-Dependent Effect of Hypocalcaemia on Mortality of Patients with Critical Bleeding Requiring Massive Transfusion: A Cohort Study. Transfusion-Related Hypocalcemia After Trauma. doi:10.1097/TA.0000000000002570

Hyperthermia / Hypothermia

Hyperthermia / Hypothermia Resuscitation Administration Blood Transfusions

ICU Physiology in 1000 Words: The Right Atrial Pressure Does Not Determine Cardiac Output – Part 2

PulmCCM

NOVEMBER 17, 2023

In the second thought experiment, let us consider a patient with significant blood volume loss that is replenished with a series of blood transfusions. The ultrasound journal 2020, 12(1):1-12. This gives the appearance of causation, but it is an association. Am J Cardiol 1990, 66(4):493-496.

Operations

Operations Ultrasounds Resuscitation Blood Transfusions

TXA – an update

PHEM Cast

NOVEMBER 28, 2022

Anti‐fibrinolytic use for minimising perioperative allogeneic blood transfusion. JAMA Surg 2020. British Journal of Anaesthesia, Volume 126, Issue 1,2021 [link] Henry DA, Carless PA, Moxey AJ, O’Connell D, Stokes BJ, Fergusson DA, Ker K. Cochrane Database of Systematic Reviews 2011, Issue 3. DOI: 10.1002/14651858.CD001886.pub4.

Blood Transfusions

Blood Transfusions Administration Research

emDOCs Podcast – Episode 96: Lower GI Bleeding

EMDocs

MARCH 6, 2024

Red Blood Cell Transfusion: 2023 AABB International Guidelines. Restrictive versus liberal blood transfusion for gastrointestinal bleeding: A systematic review and meta-analysis of randomised controlled trials. 2020 Feb;58(2):217-233. 2023 Nov 21;330(19):1892-1902. Odutayo A, Desborough MJR, Trivella M, et al.

Blood Transfusions

Blood Transfusions Outcomes Resuscitation Hospitals

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

EMDocs

JUNE 3, 2023

Effects of tranexamic acid on death, vascular occlusive events, and blood transfusion in trauma patients with significant haemorrhage (CRASH-2): a randomised, placebo-controlled trial. Published 2020 Dec 4. Published 2020 Dec 30. 2021;52(10):2697-2701. doi:10.1016/j.injury.2020.01.042 2010;376(9734):23-32. doi:10.1097/TA.0000000000003440

Fractures

Fractures Resuscitation Operations EMS

What does the ECG show in this patient with chest pain, hypotension, dyspnea, and hypoxemia?

Dr. Smith's ECG Blog

AUGUST 14, 2023

While possible that this rhythm could reflect the "fast-slow" form of AVNRT (ie, as shown in my Figure-3 of the March 6, 2020 post ) — this "fast-slow" form of AVNRT is very uncommon, and usually manifests a sharper and deeper negative deflection for the retrograde P wave. I doubt that the rhythm is a reentry SVT.

EKG/ECG

EKG/ECG Blood Transfusions Wellness

Emergency Care Today

There will be blood

Trick of Trade: Dual Foley catheter to control massive epistaxis

Trending Sources

Are we on the right TRACT?

emDOCs Podcast – Episode 100: Acute Chest Syndrome Part 1

emDOCs Podcast – Episode 101: Acute Chest Syndrome Part 2

The Latest in Critical Care, 11/6/23 (Issue #19)

Massive Transfusion for Motorcycle Collision with Hemorrhage, Troponin Elevated.

Bubble Wrap PLUS – January 2024

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

Is there Wenckebach? An Elderly Patient with a Fall

Subarachnoid hemorrhage: ED presentation, evaluation, and management

emDOCs Revamp – Acute Chest Syndrome

Imported Malaria

MTP Activation Criteria For Pediatric Patients

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

Trauma Resuscitation Updates

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

ICU Physiology in 1000 Words: The Right Atrial Pressure Does Not Determine Cardiac Output – Part 2

TXA – an update

emDOCs Podcast – Episode 96: Lower GI Bleeding

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

What does the ECG show in this patient with chest pain, hypotension, dyspnea, and hypoxemia?

Stay Connected