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CRYOSTAT-2: Early Empiric Cryoprecipitate in Major Trauma

RebelEM

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.

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Best Of AAST #7: How Do You Like Your Platelets – Warm Or Cold?

The Trauma Pro

Until the last few years, massive transfusion in trauma consisted of component therapy, an admixture of packed red cells, plasma, and platelets. Whole blood transfusion is making inroads again, but it is used in a minority of centers. They identified soldiers who received either room-temperature or cold-stored platelets.

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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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Low Risk Intra-Abdominal Trauma: Rebaked Morsel

Pediatric EM Morsels

Cohort of 12,000 children with blunt IAI were prospectively enrolled to determine the number of subjects requiring acute intervention .

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

RebelEM

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? 1.00 (0.9 – 1.12) Secondary Outcome Mortality 24h 9.7% Prehospital Tranexamic Acid for Severe Trauma.

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

PulmCCM

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., The balloon generally required 30 minutes to insert. Read in JAMA

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

Don't Forget the Bubbles

Either is reasonable as first-line, and there are not currently any studies which directly compare outcomes against each other for children with septic shock. 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.

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