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

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 90

Hyperthermia / Hypothermia Resuscitation Administration Blood Transfusions 90

The Trauma Pro

SEPTEMBER 20, 2023

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.

Military 113

Military Blood Transfusions Administration Outcomes 113

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? This should continue to make TXA part of standard trauma resuscitation while additional studies are performed.

Outcomes 105

Outcomes Blood Transfusions 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. This can interrupt massive blood loss and buy time for potentially life-saving damage control surgery.

Blood Transfusions 88

Blood Transfusions Operations Resuscitation Infectious Diseases 88

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 124

Operations Ultrasounds Resuscitation Blood Transfusions 124

Don't Forget the Bubbles

NOVEMBER 27, 2023

Four-year-old Ed is being resuscitated for presumed Invasive Group A Streptococcal Sepsis from tonsilitis. Obviously, one also needs to address the cause of the shock, or any efforts in resuscitation will only bring a temporary improvement. Myth busting: Is peripheral administration safe? After 40ml/kg of IV 0.9%

Shock 143

Shock Sepsis Fluid Resuscitation Resuscitation 143