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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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Rethinking Fluid Resuscitation in Vaso-Occlusive Crisis: Is Lactated Ringer’s the Superior Choice?

RebelEM

Within this population, over 90% of healthcare encounters are due to painful vaso-occlusive episodes (VOE) ( Kidwell 2021 ). The enrollment was multicenter, large, and adequately powered for clinically meaningful changes in outcome. Lactated Ringer (LR) and 0.9% Cross-validation was performed.

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Are we on the right TRACT? 

Don't Forget the Bubbles

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.

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

PulmCCM

patients infected with the Wuhan/Delta variants in 2020-2021). I recall very well my (unjustified) negative view on convalescent plasma in 2020 and 2021 — it was probably minimally effective, and I would never spontaneously offer it. Thromboelastometry (e.g., The balloon generally required 30 minutes to insert.

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

EMDocs

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. 2021 Mar;41:104-109.

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Bubble Wrap PLUS – January 2024

Don't Forget the Bubbles

Data collected from 2002 to 2021 revealed a 72% decline in IPD incidence among children (<18 years), with continued reductions after the transition from PCV7 to PCV13. During the COVID-19 pandemic (2020-2021), the incidence of IPD reached its lowest level in 20 years. Outcomes From a Randomized Clinical Trial. JAMA Pediatr.

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Transfusion in acute MI: what's the right hemoglobin target?

PulmCCM

However, large observational cohorts have associated greater degrees of anemia with worse outcomes in patients with cardiac disease. In MINT, 3,504 patients with acute myocardial infarction and anemia were randomized to either a transfusion threshold of ≤8 g/dL, or a liberal transfusion threshold of ≤10 g/dL.