Administration, Blood Transfusions and EMS

Low Risk Intra-Abdominal Trauma: Rebaked Morsel

Pediatric EM Morsels

MAY 24, 2024

Evaluation of unintentional injury and trauma is one of the hallmarks of the EM and PEM physician. Low Risk Inta-Adbominal Trauma: Just Light ‘Em Up? The post Low Risk Intra-Abdominal Trauma: Rebaked Morsel appeared first on Pediatric EM Morsels. J Am Coll Surg. 2017;224:449-460. doi:10.1016/j.jamcollsurg.2016.12.041.

Pediatrics

Pediatrics Blood Transfusions EMS Fractures

Imported Malaria

Pediatric EM Morsels

NOVEMBER 3, 2023

For non-complicated malaria use oral Co ART em. Food and Drug Administration Approval of Artesunate for Severe Malaria: Enough to Achieve Best Practice? PMID: 30666615 The post Imported Malaria appeared first on Pediatric EM Morsels. Treating malaria is an ART! Add oral Primaquine if known to have P. vivax or P.

Seizures

Seizures Pediatrics CDC Infectious Diseases

CRYOSTAT-2: Early Empiric Cryoprecipitate in Major Trauma

RebelEM

OCTOBER 30, 2023

Most major hemorrhage protocols give a balanced transfusion of PRBCs, FFP, and platelets in ratios approaching concentrations found in whole blood. The optimal approach to fibrinogen administration in massive hemorrhage protocols is unknown. Fibrinogen products may also be needed to stabilize clots and stem bleeding.

Administration

Administration Blood Transfusions Outcomes Hospitals

ToxCard: Iron

EMDocs

DECEMBER 6, 2024

In 1997, the Food and Drug Administration (FDA) mandated unit-dose packaging for all iron-containing products with more than 30 milligrams of elemental iron. Blood transfusion for clinically significant blood loss. Can titrate up to maximum of 40 mg/kg/hr, although hypotension may limit dose of deferoxamine.

Poisoning

Poisoning Fluid Resuscitation Seizures Resuscitation

Rethinking the Role of TXA: Are We Asking Too Much?

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? Read More Core EM: CRASH-2: Tranexamic Acid in Major Trauma References: CRASH-2 Trial Collaborators.

Blood Transfusions

Blood Transfusions Outcomes Administration Hyperthermia / Hypothermia

Trauma Resuscitation Updates

RebelEM

MAY 25, 2023

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. Intensive Care Med 2020. [13]

Resuscitation

Resuscitation Fluid Resuscitation Head Injuries Shock

Vasopressor Nonresponse

Northwestern EM Blog

JANUARY 24, 2022

And for most forms, EM physicians are not typically shocked by shock. 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.

Anaphylaxis

Anaphylaxis Shock Sepsis Resuscitation

Grand Rounds Recap 4.26.23

Taming the SRU

MAY 30, 2023

billion passengers annually 1 medical emergency per 604 flights Most common complaints: Syncope/presyncope: 37.4% Respiratory symptoms: 12.1% Nausea and vomiting: 9.5% Diversion occurs 7.3% of in-flight emergencies Deaths occurred 0.3% Smith Quick Facts regarding In-Flight Emergencies: 2.75 Respiratory symptoms: 12.1% Nausea and vomiting: 9.5%

OB/GYN

OB/GYN Ultrasounds Pediatrics Resuscitation

Episode 21- Updates and Controversies in the Early Management of Sepsis and Septic Shock

EB Medicine

OCTOBER 1, 2018

Jeff : I’m an EMS fellow, what can I say… Anyway, on to my favorite section -- prehospital care. This is always a hot topic because the prehospital period is a special opportunity to get early interventions in for septic patients as 40 - 70% of all severe sepsis hospitalizations arrive via EMS. What does that mean?

Sepsis

Sepsis Shock Fluid Resuscitation Hospitals

The AcT Trial: Tenecteplase vs Alteplase for Acute Ischemic Stroke

RebelEM

FEBRUARY 1, 2024

Tenecteplase, a modified version of alteplase, is being increasingly utilized for AIS due to its favorable pharmacological profile, ease of administration, and cost effectiveness. Earlier studies looking at tenecteplase dosing began in 2005 and have largely settled on a dose of 0.25 mg/kg at this time for the potential treatment of AIS.

Stroke

Stroke Blood Transfusions Outcomes EMS

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

EMDocs

JUNE 3, 2023

Her initial vital signs are blood pressure 76/54 mmHg, heart rate 128 bpm, temperature 37.0˚ What is the EM physician’s role in the stabilization of unstable pelvic injuries? If a pelvic binder was placed by EMS, inquire whether this was placed empirically or if mechanical pelvic instability was already elicited.

Fractures

Fractures Resuscitation Operations EMS

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

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. appeared first on REBEL EM - Emergency Medicine Blog. Lactated Ringer (LR) and 0.9%

Fluid Resuscitation

Fluid Resuscitation Resuscitation Documentation/Coding Outcomes

Grand Rounds Recap 5.3.23

Taming the SRU

JUNE 6, 2023

mg/kg of IBW Seek to match a patient's minute ventilation with TV and RR after intubation Intentionally match patient's intrinsic RR noted prior to intubation Note that healthy lungs can handle 8 mL/kg, based on IBW, if that is useful for compensation Secure your ETT Thomas Tube Holder is a new ETT holder on Air Care for ETT down to size 6.5

Documentation/Coding

Documentation/Coding Seizures Psychiatric Wellness

Emergency Care Today

Low Risk Intra-Abdominal Trauma: Rebaked Morsel

Imported Malaria

Trending Sources

CRYOSTAT-2: Early Empiric Cryoprecipitate in Major Trauma

ToxCard: Iron

Rethinking the Role of TXA: Are We Asking Too Much?

Trauma Resuscitation Updates

Vasopressor Nonresponse

Grand Rounds Recap 4.26.23

Episode 21- Updates and Controversies in the Early Management of Sepsis and Septic Shock

The AcT Trial: Tenecteplase vs Alteplase for Acute Ischemic Stroke

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

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

Grand Rounds Recap 5.3.23

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