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REBEL Cast Ep 118: The PROCOAG Trial – 4F-PCC for Trauma Patients?

RebelEM

Interventions such as early application of hemorrhage control, tranexamic acid, reduction of crystalloid fluid administration and balanced ratio blood product transfusion have improved many patients’ outcomes. Click here for Direct Download of the Podcast Paper: Bouzat P et al. Severe acute traumatic coagulopathy = PT >1.5

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Major Trauma – Injuries by Assault

Don't Forget the Bubbles

This should include early identification of life-threatening injuries, targeted fluid resuscitation using blood products, pain management, then eventual safeguarding and psychological support. Establish IV access for potential fluid resuscitation. You feel the patient needs fluid resuscitation. Administer O2 if necessary.

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ICU Physiology in 1000 Words: The Right Atrial Pressure Does Not Determine Cardiac Output – Part 2

PulmCCM

shows blood administration with a direct linear relationship between Pra and CO/VR; only Pmsf is varied here. Operating point guided resuscitation How do we make sense of this? The trick, I believe, lies in ‘operating point guided resuscitation’ [OPGR]. Download his free textbook here. OP is operating point.

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Crafting And Refining Your Massive Transfusion Protocol – Part 3

The Trauma Pro

The Broxton tool covers all the basics and includes some additional data points that cover activation criteria, TXA administration, and administration of uncrossmatched blood. You can download a copy by clicking here. Click here to check it out. In the next post, I’ll continue with activation criteria for the MTP.

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REBEL Cast Ep120: Etomidate vs Ketamine for RSI in the ED?

RebelEM

Background: Standard rapid sequence intubation (RSI) in the emergency department involves administration of an induction agent and a neuroblocking agent in quick succession. Click here for Direct Download of the Podcast Paper: Knack SKS et al. REBEL Cast Ep120: Etomidate vs Ketamine for RSI in the ED?

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REBEL Cast Ep116: The CLOVERS Trial – Restrictive vs Liberal Fluids in Sepsis-Induced Hypotension

RebelEM

Background: IV fluids are part of the standard resuscitation bundle in septic shock, however it is unclear if they provide a significant benefit. However, there is a lack of robust evidence to help guide what fluid and vasopressor strategy is best in patients with septic shock. Liberal: 14.9% Estimated Difference: -0.9%; 95% CI 04.4

Sepsis 99
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REBEL Cast Ep122 – Delayed vs Rapid Sequence Intubation in Agitated Trauma Patients

RebelEM

Traditional RSI entails preoxygenation followed by near-simultaneous administration of an induction agent followed by a neuromuscular blocker. REBEL Cast Ep122: Delayed vs Rapid Sequence Intubation in Agitated Trauma Patients Click here for Direct Download of the Podcast Paper: Bandyopadhyay A et al.