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ToxCard: Iron

EMDocs

Blood transfusion for clinically significant blood loss. 5 Consider exchange transfusion in addition to deferoxamine for serum iron concentrations greater than 1000 g/dL, or those who clinically deteriorate despite supportive care and chelation. Radiology in the management of acute iron poisoning. doi: 10.1097/PEC.0b013e3182302604.

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Trauma Resuscitation Updates

RebelEM

Lancet 2010 [10] >20,000 adult trauma patients with SBP <90mmHg Patients randomized to TXA 1g over 10 min + 1g IV over 8hrs vs Placebo given within 8hrs of injury In-hospital mortality by 28d reduced (14.5% NEJM 1994. [2]

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NFTI And STAT: Can They Replace The Cribari Grid?

The Trauma Pro

It also standardizes comparisons between hospitals that use STAT. Once again, let’s look at over- and undertriage experience in the paper: Undertriage: 9.1% undertriage (Cribari) reduced to 3.3% This may be helpful for future triage-related research. What Does It All Mean?

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Episode 16: “Blood”

PHEM Cast

Priorities for the bleeding trauma patient must include: Minimum time to control of bleeding (tourniquets / haemostatics / knife / interventional radiology) Normothermia Appropriate choice of destination (knife / IR) ? Prehospital transfusion of plasma and red blood cells in trauma patients. Prehosp Emerg Care 19(1):1–9, 2015.

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emDOCs Podcast – Episode 96: Lower GI Bleeding

EMDocs

In other patients who are stable and the bleeding has resolved, CTA is of low yield If they are critically ill and have severe bleeding, resuscitate first and consult IR, radiology, and surgery. 2023 ACG guidelines recommend against transfusing platelets to reverse an antiplatelet agent. 2023 Nov 21;330(19):1892-1902. 2017;2(5):354–60.

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Subarachnoid hemorrhage: ED presentation, evaluation, and management

EMDocs

10,11 Magnetic resonance imaging (MRI) is not recommended as a primary imaging modality for the diagnosis of SAH due to test duration (which can delay life-saving interventions), as well as the fact that the mixing of blood with cerebrospinal fluid (CSF) may delay the transition of hemoglobin to its deoxyhemoglobin state that is best imaged on MRI.

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

EMDocs

Her Glasgow Coma Scale (GCS) is 14 (3E-5V-6M), and she arrives in a cervical collar placed pre-hospital. 6 Especially for the 15% of unstable pelvic fracture patients who have arterial bleeding, angioembolization performed in the interventional radiology (IR) suite or operating room will provide critical source control. doi:10.1097/TA.0b013e3182ab0cde