RebelEM

MAY 25, 2023

CRYSTALLOIDS Too much crystalloid resuscitation in traumatic hemorrhagic shock can increase dilutional coagulopathy, as well as increase morbidity and mortality Bickell WH et al. I recently gave a talk on the initial management of trauma patients with hemorrhagic shock. vs SBP target <90mmHg which resulted in a mortality of 33.4%

Resuscitation 145

Resuscitation Fluid Resuscitation Head Injuries Shock 145

The Trauma Pro

JUNE 18, 2024

Early resuscitation, particularly with blood products in patients with hemorrhage, is literally a lifesaver. To facilitate this, massive transfusion protocols (MTP) have been designed to rapidly deliver sizable quantities of blood products to the trauma resuscitation bay. 2020 Feb;55(2):331-334.

Pediatrics 113

Pediatrics Blood Transfusions Resuscitation Shock 113

EMDocs

JUNE 12, 2024

Calcium and resuscitation Severely injured trauma patients are commonly hypocalcemic. Up to 56% have an ionized Ca < 1 mmol/L, and this increases mortality and need for transfusion. Transfusion induced hypoCa is common in patients undergoing massive transfusion. HypoCa was associated with 49% mortality (vs 24%).

Hyperthermia / Hypothermia 89

Hyperthermia / Hypothermia Resuscitation Administration Blood Transfusions 89

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). Limited data were available regarding its efficacy.

Blood Transfusions 98

Blood Transfusions Operations Resuscitation Infectious Diseases 98

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. Operating point guided resuscitation How do we make sense of this? The trick, I believe, lies in ‘operating point guided resuscitation’ [OPGR].

Operations 132

Operations Ultrasounds Resuscitation Blood Transfusions 132

EMDocs

MAY 15, 2024

Fluid management Goal is euvolemia Dehydration – needs IV fluid resuscitation. 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 78

Blood Transfusions Fluid Resuscitation Dehydration Ultrasounds 78

EMDocs

MAY 28, 2024

Fluid management Goal is euvolemia Dehydration – needs IV fluid resuscitation. Blood transfusion Reduces the overall proportion of HbS. American Society of Hematology 2020 guidelines for sickle cell disease: transfusion support. Published 2020 Feb 12. Decreases splinting and improves tidal volumes.

Blood Transfusions 75

Blood Transfusions Fluid Resuscitation Dehydration Ultrasounds 75