EMDocs

JUNE 12, 2024

Two randomized controlled trials by Moore et al found that prehospital plasma administration in trauma patients is associated with hypoCa (53% vs 36%). Prehospital transfusion of pRBCs is also associated with lower ionized Ca levels, and the degree of hypoCa correlates with the number of blood products transfused.

Hyperthermia / Hypothermia 105

Hyperthermia / Hypothermia Resuscitation Administration Blood Transfusions 105

RebelEM

JUNE 19, 2023

PMID: 37314244 Clinical Question: In advanced trauma systems, does prehospital administration of TXA increase the rate of survival with a favorable neurologic outcome in patients at risk for trauma-induced coagulopathy? Article: PATCH-Trauma Investigators and ANZICS Clinical Trial Group. Prehospital Tranexamic Acid for Severe Trauma.

Blood Transfusions 105

Blood Transfusions Outcomes Administration Hyperthermia / Hypothermia 105

PulmCCM

NOVEMBER 6, 2023

Uncertainty has persisted about the ideal blood transfusion strategy to resuscitate and support trauma victims as they are prepared to undergo surgical and other mechanical interventions to achieve hemostasis. Thromboelastometry (e.g., Read in JAMA

Blood Transfusions 98

Blood Transfusions Operations Resuscitation Infectious Diseases 98

PulmCCM

NOVEMBER 17, 2023

shows blood administration with a direct linear relationship between Pra and CO/VR; only Pmsf is varied here. In the second thought experiment, let us consider a patient with significant blood volume loss that is replenished with a series of blood transfusions. OP is operating point. See text for details.

Operations 132

Operations Ultrasounds Resuscitation Blood Transfusions 132

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. Myth busting: Is peripheral administration safe? Shock and sepsis itself can cause low calcium levels due to intracellular shifts and lactate-binding calcium.

Shock 143

Shock Sepsis Fluid Resuscitation Resuscitation 143

Downeast Emergency Medicine

APRIL 26, 2021

2][3] If earlier treatment with TXA is better, would there be benefit in its administration in the prehospital setting? Association between prehospital tranexamic acid administration and outcomes of severe traumatic brain injury. Blood Coagul Fibrinolysis. If so, could this be done safely? JAMA Neurol. 2021;78(3):338–345.

Head Injuries 52

Head Injuries Administration Outcomes Seizures 52

Northwestern EM Blog

JANUARY 24, 2022

At those levels, bicarbonate administration has not been shown to improve cardiac output, MAP or pressor response. For example, a patient in cardiogenic shock will likely worsen with the administration of fluids and the wrong vasopressors. A loading dose of 100mg IV should be given, followed by 50mg every 6 hours thereafter.

Anaphylaxis 52

Anaphylaxis Shock Sepsis Resuscitation 52

Taming the SRU

MAY 30, 2023

mg single-dose 5-mL ampule or equivalent, 2 Aspirin, 325-mg tablets, 4 Bronchodilator, metered-dose inhaler or equivalent 50% Dextrose injection, single-dose 50-mL ampule or equivalent Epinephrine injection, 1:1000 (1 mg/mL) single-dose 1-mL ampule or equivalent, 2 Epinephrine injection, 1:10,000 (0.1

OB/GYN 52

OB/GYN Ultrasounds Pediatrics Resuscitation 52

EB Medicine

OCTOBER 1, 2018

Current guidelines recommend that broad spectrum antibiotics be administered within the first hour of presentation for those with sepsis or septic shock, ideally with blood cultures being drawn beforehand. In one study, every hour of delayed abx administration was associated with an 8% increase in mortality.

Sepsis 40

Sepsis Shock Fluid Resuscitation Hospitals 40

American Medical Compliance

JANUARY 23, 2024

The following Comprehensive Blood Administration Training is designed to educate healthcare providers on various blood products. Also, a variety of healthcare professionals handle blood products. The post Comprehensive Blood Administration Training appeared first on American Medical Compliance.

Administration 52

Administration Blood Transfusions Infectious Diseases Documentation/Coding 52

Taming the SRU

OCTOBER 25, 2023

100U (30-60 min prior), 0.25-0.375/100U

Blood Transfusions 98

Blood Transfusions Stroke Hospitals Anaphylaxis 98

PHEM Cast

NOVEMBER 28, 2022

Here are some links to the excellent Life in the Fast Lane: [link] [link] Acute Coagulopathy of Trauma Tranexamic Acid The Resus Room podcast which discusses Tim and colleagues paper on gender differences in TXA administration is available here: [link] Want to read more about Crash 4? Cochrane Database of Systematic Reviews 2011, Issue 3.

Blood Transfusions 52

Blood Transfusions Administration Research 52

EMDocs

JUNE 3, 2023

Early administration of antibiotics may not be prioritized in the setting of hemodynamic instability but antibiotics are a critical portion of management if open fracture is suspected. 12 An AP x-ray of the pelvis should be obtained in the ED for unstable patients. 2021;52(10):2697-2701. doi:10.1016/j.injury.2020.01.042 2010;376(9734):23-32.

Fractures 66

Fractures Resuscitation Operations EMS 66

Don't Forget the Bubbles

JULY 5, 2023

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. In these cases, repeat the Hb electrophoresis three months after the last blood transfusion. Would you consider this patient for blood transfusion?

Blood Transfusions 126

Blood Transfusions Stroke Dehydration Sepsis 126

Don't Forget the Bubbles

JANUARY 1, 2024

Hemoglobin Threshold for Blood Transfusion in Young Children Hospitalized with Iron Deficiency Anemia. Late surfactant administration after 48 hours of age in preterm neonates with respiratory insufficiency: a systematic review and meta-analysis. Lo Vecchio A, et al.J 2023 Dec 20:113876. Rose Sun DL, et al. Van Vyve L, et al.

Pediatrics 98

Pediatrics Ultrasounds Blood Transfusions Sepsis 98

Emergency Medicine Journal

MARCH 25, 2025

Background Hypofibrinogenaemia on ED arrival and in the prehospital setting has been associated with both increased mortality and increased blood transfusions. receiving prehospital blood transfusions. The cohort was predominately male (82.9%) with a median age of 35 years (IQR 26–51). to 0.61).

Blood Transfusions 52

Blood Transfusions Administration Operations Hospitals 52

Emergency Medicine Journal

MARCH 25, 2025

A short systematic review of the literature was undertaken to assess whether tranexamic acid (TXA) administration in the ED for neck of femur fractures was associated with improved outcomes for patients undergoing surgery. MEDLINE, EMBASE, Cochrane and Google Scholar databases were searched.

Fractures 40

Fractures Blood Transfusions Emergency Department Administration 40

RebelEM

DECEMBER 23, 2024

VOE is often complicated by hypovolemia, making fluid administration a common intervention ( Lovett 2017 ). This introduces the risk that data may be less accurate than with prospective enrollment, access to medication administration records, etc. Lactated Ringer (LR) and 0.9% volume overload).

Fluid Resuscitation 128

Fluid Resuscitation Resuscitation Documentation/Coding Outcomes 128

Taming the SRU

JUNE 6, 2023

Disposition Indications for admission GCS<15, focal neurological deficits, seizures Intractable vomiting Significant Abnormal CT results Discharge criteria Normal GCS, exam Caregiver at home Certain abnormal CT Isolated & non-depressed calvarial skull fractures <1cm diameter of solitary cerebral contusions <1cm width of epidural or (..)

Documentation/Coding 64

Documentation/Coding Seizures Psychiatric Wellness 64

Don't Forget the Bubbles

NOVEMBER 18, 2024

Perinatal Blood Loss: Significant blood loss during delivery, whether due to placental abruption, vasa previa, or traumatic delivery, can result in anaemia and subsequent hypotension. If anaemia is confirmed, a blood transfusion may be necessary to restore adequate circulatory volume and improve oxygen-carrying capacity.

Sepsis 59

Sepsis Shock Hyperthermia / Hypothermia Administration 59