JournalFeed

FEBRUARY 17, 2024

The JournalFeed podcast for the week of Feb 12-16, 2024. These are summaries from just 2 of the 5 article we cover every week! For access to more, please visit JournalFeed.org for details about becoming a member.

Blood Transfusions 52

Blood Transfusions Resuscitation Hospitals 52

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

PulmCCM

JUNE 22, 2024

When it comes to red blood cell transfusion during critical illness, less is more, generally speaking. Because transfusion can be harmful, current practice is to usually restrict it in the ICU to patients with hemoglobin less than 7 g/dL. Some patients, though (e.g.,

Blood Transfusions 52

Blood Transfusions 52

The Trauma Pro

MAY 26, 2023

Possible interventions were none, operation, angioembolization, or blood transfusion. They examined how often serial hemoglobin determinations influenced management during the study period. That patient had a laparotomy based on the lab test.

Blood Transfusions 100

Blood Transfusions Operations Pediatrics Hospitals 100

Don't Forget the Bubbles

JANUARY 10, 2024

Transfusion Decisions in Severe Anaemia Reducing child mortality remains high on the global health agenda. Let’s take the humble blood transfusion – used in emergency departments across the globe and playing a key role in critical care. However, there is a huge variation in transfusion practice globally.

Blood Transfusions 78

Blood Transfusions Outcomes Research Hospitals 78

The Trauma Pro

OCTOBER 10, 2023

This can result in catastrophic errors if test results are misinterpreted, or a blood transfusion with incorrect ABO typing is given to the wrong patient. There are too many opportunities to mix up similar names, especially if the last one is always the same. Some use number and letter sequences combined with another unique word.

Blood Transfusions 113

Blood Transfusions Best Practices Hospitals Wellness 113

Taming the SRU

JUNE 26, 2024

Other medical interventions include PPIs, octreotide, erythromycin, and blood transfusion as needed. Blood transfusion may be useful in patients with penetrating trauma, although we must acknowledge when efforts are futile. Early endoscopy is key to both diagnosis and therapeutics.

Blood Transfusions 86

Blood Transfusions Sepsis CPR EKG/ECG 86

Pediatric EM Morsels

MAY 24, 2024

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

Pediatrics 161

Pediatrics Blood Transfusions EMS Fractures 161

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

ALiEM

MAY 29, 2023

Because he presumably had uremia-induced thrombasthenia (weak platelets), he received blood transfusions and IV TXA. We thus removed the anterior packing and instead inserted a Foley catheter into the posterior nasal space and inflated the balloon. Unfortunately, the bleeding still continued.

Blood Transfusions 98

Blood Transfusions Emergency Department Shock Hospitals 98

The Trauma Pro

JUNE 18, 2024

Several adult and pediatric trauma centers in the Denver area collaborated to test a new score using the ABC-S score in combination with serum lactate and base deficit. This was termed the ABC-D score.

Pediatrics 113

Pediatrics Blood Transfusions Resuscitation Shock 113

Pediatric EM Morsels

NOVEMBER 3, 2023

It is characterized by a variety of symptoms from mild ataxia or tremor alone to severe encephalopathy accompanied with fever, seizures, aphasia, and sometimes psychiatric symptoms (Yadava 2019) Treatment with artesunate can lead to Post-Artesunate Delayed Hemolysis (PADH) (Forgie 2022) Typically seen 7-21 days after treatment 15% of those treated (..)

Seizures 278

Seizures Pediatrics CDC Infectious Diseases 278

Sensible Medicine

NOVEMBER 27, 2023

But, on the other hand, giving blood comes with the risk of volume overload, infection, clotting and inflammation. But, in general, blood transfusion strategies have been studied in many other clinical situations. Previous trials of treating anemia in post-MI patients have been small and inconclusive.

Blood Transfusions 98

Blood Transfusions Outcomes Hospitals 98

Sensible Medicine

SEPTEMBER 20, 2024

It may not feel as satisfying as diagnosing an upper GI bleed and seeing the patient feel better after a blood transfusion, but it’s just as vital a part of our job.

Blood Transfusions 100

Blood Transfusions Wellness 100

PulmCCM

MAY 17, 2024

But thanks to the safety of the blood supply—in particular, the mitigation strategies in place to prevent transfusion reactions—TRALI occurs rarely. After stopping any blood transfusion in process, TRALI is generally treated with supportive care. How O… Read more

Blood Transfusions 59

Blood Transfusions 59

ALiEM

NOVEMBER 3, 2023

Highlighted Quality Posts: Trauma Site Article Author Date Label Rebel EM Trauma Resuscitation Update Salim Rezaie, MD May 25, 2023 AIR EM Docs Unstable Pelvic Trauma Patient Luke Wohlford, MD June 3, 2023 AIR EM Docs Maxillofacial Trauma Forrest Turner, MD October 17, 2022 AIR Rebel EM PATCH trauma trial Anand Swaminathan, MD June 19, 2023 HM Don’t (..)

Blood Transfusions 84

Blood Transfusions EMS Emergency Department Resuscitation 84

EMDocs

MAY 15, 2024

Management includes rapid initiation of opioid and non-opioid agents to treat the pain associated with vaso-occlusive crisis, antimicrobial coverage, incentive spirometry, oxygen supplementation to maintain saturation > 95%, fluid resuscitation based on volume status, consideration for transfusion, and specialist consultation.

Blood Transfusions 78

Blood Transfusions Fluid Resuscitation Dehydration Ultrasounds 78

PEMBlog

APRIL 24, 2024

Retrospective use has been shown to be valid and reliable in one cross-sectional study ( Beslow 2012 ).This Early consultation with a pediatric hematologist and neurologist is mandatory. References / Key Articles Ichord RN, Bastian R, Abraham L, et al.

Stroke 59

Stroke Pediatrics Blood Transfusions Radiology 59

RebelEM

MAY 25, 2023

The Role of Whole Blood Transfusions in Civilian Trauma: A Review of Literature in Military and Civilian Trauma. Effects of tranexamic acid on death, vascular occlusive events, and blood transfusion in trauma patients with significant haemorrhage (CRASH-2): a randomised, placebo-controlled trial. Cureus 2022.

Resuscitation 145

Resuscitation Fluid Resuscitation Head Injuries Shock 145

EMDocs

MAY 28, 2024

Blood transfusion Reduces the overall proportion of HbS. Simple blood transfusion should be considered early in the hypoxemic patient with advancement to red cell exchange transfusion if there are clinical features of severe pathology or evidence of progression despite initial simple transfusion.

Blood Transfusions 75

Blood Transfusions Fluid Resuscitation Dehydration Ultrasounds 75

RebelEM

OCTOBER 30, 2023

This would normally make me worry about dilution of results and biasing the results to the null hypothesis, but in the per protocol analysis (170 patients excluded from the full cohort, due to no longer requiring blood transfusion, dying within 90 minutes of arrival or being randomized in error) didn’t seem to affect this result either.

Administration 128

Administration Blood Transfusions Outcomes Hospitals 128

PulmCCM

OCTOBER 3, 2023

Among 324 patients with trauma and life-threatening bleeding at 12 French hospitals who were randomized to receive 1ml/kg PCC or placebo, there was no reduction observed in 24-hour blood transfusion needs in the PCC group. PCC was associated with a significantly higher risk for thromboembolic complications (35% vs 24%). Read in JAMA

Blood Transfusions 52

Blood Transfusions Hospitals 52

Emergency Medicine Cases

JUNE 27, 2017

Dr. Lloyd reviews how to avoid needless blood transfusions, the indications for IV iron and how to actually administer IV iron, while Dr. Clarridge reviews a novel approach, causes, complications and management of hyponatremia in the ED.

Blood Transfusions 52

Blood Transfusions EMS 52

EMergucate

MAY 17, 2016

Anaemia Anticoagulants Bleeding Disorders Blood Transfusion Reactions Blood Transfusions DIC Haemoglobinopathies Haemostasis & Coagulation Methaemoglobinaemia Neutropaenia Platelet Disorders Thrombophilia

Blood Transfusions 40

Blood Transfusions EMS 40

University of Maryland Department of Emergency Med

AUGUST 18, 2023

In this small propensity matching study looking at prehospital blood transfusion vs. emergency department blood transfusion in trauma patients ag. Click to view the rest

Blood Transfusions 40

Blood Transfusions Pediatrics Emergency Department 40

The Trauma Pro

MAY 10, 2024

They reviewed 2.5 years of their registry data (Level I center).

Blood Transfusions 113

Blood Transfusions Documentation/Coding Radiology Radiology 113

Intensive Blog

AUGUST 17, 2023

What is an appropriate “trigger threshold” for blood transfusion in ECMO patients? Blood transfusion is common in ECMO patients, as evidenced by almost 90% of all patients receiving at least one packed red blood cell transfusion during VV-ECMO support (Kalbhenn and Zieger, 2022). 2020.08.068.

Blood Transfusions 52

Blood Transfusions Operations Wellness 52

The Skeptics' Guide to EM

DECEMBER 17, 2022

Massive Blood Transfusion Following Older Adult Trauma: the Effect of Blood Ratios on Mortality. Case: A […] The post SGEM386: Blood on Blood – Massive Transfusion Protocols in Older Trauma Patients first appeared on The Skeptics Guide to Emergency Medicine. Date: December 16th, 2022 Reference: Hohle et al.

Blood Transfusions 52

Blood Transfusions Fractures EMS Emergency Department 52

Don't Forget the Bubbles

MAY 8, 2023

Most require no regular treatment, but some may require either occasional or regular blood transfusions. Regular transfusions may ease symptoms but carry the risk of iron overload, resulting in a need for chelation therapy and ongoing monitoring with serum ferritin and Ferriscan imaging.

Blood Transfusions 52

Blood Transfusions 52

EMergucate

AUGUST 23, 2017

An 80 year old women with severe anaemia secondary to GI bleed Severe anaemia requiring urgent blood transfusion, correction of … Continue reading →

Blood Transfusions 40

Blood Transfusions Resuscitation EMS 40

The Bottom Line

DECEMBER 17, 2024

NEJM 2024 DOI:10.1056/NEJMoa2410962 Clinical Question In patients following acute aneurysmal subarachnoid haemorrhage, does a liberal strategy of blood transfusion compared with a restrictive strategy of blood transfusion reduce unfavourable neurological outcome?

Blood Transfusions 59

Blood Transfusions Outcomes 59

RebelEM

JUNE 19, 2023

Effects of tranexamic acid on death, vascular occlusive events, and blood transfusion in trauma patients with significant haemorrhage (CRASH-2): A randomised, placebo-controlled trial. Read More Core EM: CRASH-2: Tranexamic Acid in Major Trauma References: CRASH-2 Trial Collaborators. Lancet 2010; 376(9734): 23-32.

Outcomes 105

Outcomes Blood Transfusions Administration Hyperthermia / Hypothermia 105

ACEP Now

MAY 3, 2023

Management requires hospitalization for hydration, oxygenation, intravenous antibiotics, pain control, and blood transfusions and, in some cases, exchange transfusion. See the original question here.) Member Benefit: All ACEP members receive a 20 percent discount on VisualDX. Reference Winter MW, Ingerowski E, Prasad P.

Blood Transfusions 52

Blood Transfusions Hospitals 52

PulmCCM

NOVEMBER 17, 2023

In the second thought experiment, let us consider a patient with significant blood volume loss that is replenished with a series of blood transfusions. This gives the appearance of causation, but it is an association. Again, to simplify this thought experiment, we assume that P pc , R vr and R cardiac are constant [Figure 1B].

Operations 132

Operations Ultrasounds Resuscitation Blood Transfusions 132

EMDocs

JUNE 22, 2024

Answer : Amniotic fluid embolism Epidemiology: Incidence of 1:15,200 to 1:53,400 1 7% occur during labor Causes approximately 14% of all maternal peripartum death in United States Current fatality rate 13-60% 1-4 Risk factors: Advanced maternal age, amniocentesis, cesarean delivery, eclampsia, medical induction of labor, placental pathology, diabetes, (..)

EMS 96

EMS Resuscitation Blood Transfusions Seizures 96

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.

Blood Transfusions 98

Blood Transfusions Operations Resuscitation Infectious Diseases 98

Dr. Smith's ECG Blog

JULY 3, 2020

The patient was in shock on arrival in the ED — and multiple blood transfusions were needed. ANSWERS regarding ECG #1: Severe trauma requiring blood transfusions is a common emergency presentation. Blood and fluid volume was rapidly restored, and acidosis was probably quickly corrected. WHY is the QRS complex wide?

Blood Transfusions 52

Blood Transfusions EKG/ECG Shock Fractures 52