RebelEM

JUNE 19, 2023

Primary Results Patients enrolled from 15 emergency medical services at 21 hospitals across 3 countries over 7 years. The study is relatively small (CRASH2 enrolled > 20,000 patients); just 1300 patients from 21 hospitals over 7 years. Resides in a facility for older persons. 1310 patients were recruited and randomized.

Blood Transfusions 105

Blood Transfusions Outcomes Administration Hyperthermia / Hypothermia 105

RebelEM

SEPTEMBER 26, 2022

There was no statistically significant difference in failure to control bleeding by day 5 or failure to prevent rebleeding after day 5, total hospital length of stay in the first admission, total ICU and hospital length of stay up to 42 days, or 5 and 42-day mortality rates between the two groups. Furthermore, 14.3% Ann Intern Med.

Resuscitation 52

Resuscitation Blood Transfusions Outcomes Hospitals 52

PHEM Cast

FEBRUARY 23, 2017

Prehospital Blood Product Resuscitation for Trauma. Shorter times to packed red blood cell transfusion are associated with decreased risk of death in traumatically injured patients. .: Prehospital transfusion of plasma and red blood cells in trauma patients. Lots to think about! 2016 Jul;46(1):3–16.

Blood Transfusions 52

Blood Transfusions Head Injuries Resuscitation Radiology 52

Downeast Emergency Medicine

APRIL 26, 2021

Four level-1 US trauma centers participated in the study where the inclusion criteria were trauma patients who were within 2 hours of their injury and were transported to the trauma center from either the field or another hospital. The primary outcome was head injury-related death in-hospital within 28 days of injury.

Head Injuries 52

Head Injuries Administration Outcomes Seizures 52

Taming the SRU

APRIL 3, 2023

Cardiac Arrest in Pregnancy 1 in 30,000 pregnancies 800 maternal deaths globally Rates have nearly doubled between 1989 and 2009 Survival to hospital discharge after maternal in-hospital cardiac arrest 58.9% Do not transport to an alternative location.

Blood Transfusions 40

Blood Transfusions Fluid Resuscitation Resuscitation Stroke 40

EB Medicine

OCTOBER 1, 2018

For those listening, my hospital probably looks a little bit like yours. Roughly half of in-hospital mortality is associated with septic in some fashion. clearly this is an important topic if it warrants it’s own chair at a major hospital in NYC. At our hospital in southern Manhattan, patients tend to breathe around 16.

Sepsis 40

Sepsis Shock Fluid Resuscitation Hospitals 40

The Trauma Pro

SEPTEMBER 18, 2023

They compared adult patients who arrived as a highest-level of activation and received blood during their resuscitation. The door-to-prophylaxis time was defined as the time from hospital arrival to the first dose of medication. And the authors remind us that this study shows association, not causation.

Blood Transfusions 113

Blood Transfusions Resuscitation Hospitals Wellness 113

EMDocs

MARCH 6, 2024

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.

Blood Transfusions 105

Blood Transfusions Outcomes Resuscitation Radiology 105

EMDocs

JUNE 3, 2023

Her Glasgow Coma Scale (GCS) is 14 (3E-5V-6M), and she arrives in a cervical collar placed pre-hospital. 5 Initial Evaluation The key to the initial resuscitation of the unstable pelvic trauma patient is to rapidly identify and treat the most life-threatening pathology. Her airway is intact, and she has equal bilateral breath sounds.

Fractures 66

Fractures Resuscitation Operations EMS 66

EMDocs

JUNE 27, 2024

His medical history is significant for three prior admissions for vaso-occlusive crises that have responded well to appropriate therapy, including pain control with NSAIDs and opioids, blood transfusions, antibiotics, and intravenous (IV) crystalloids. Triage vital signs include BP 127/81, HR 119, T 102.9 C or 100.4 mg/kg, max 0.4

Pediatrics 98

Pediatrics Dehydration EMS Hospitals 98

RebelEM

DECEMBER 23, 2024

saline (NS) solutions are both isotonic crystalloids widely used for intravenous fluid resuscitation across many contexts and disease states ( Myburgh 2013 ). PMID: 39250114 Clinical Question: In adult patients admitted for a vaso-occlusive episode, does early fluid resuscitation with Lactated Ringer solution compared to 0.9%

Fluid Resuscitation 128

Fluid Resuscitation Resuscitation Documentation/Coding Outcomes 128

Pediatric EM Morsels

MARCH 7, 2025

While transfusing blood can be beneficial to those who have lost it or continue to lose it quickly, blood may not always be immediately available. Or maybe the family does not desire blood transfusions. Military Application of Tranexamic Acid in TraumaEmergency Resuscitation (MATTERs) Study. 2020;2(1):e0075.

Pediatrics 231

Pediatrics Blood Transfusions Anaphylaxis Military 231

Taming the SRU

JUNE 6, 2023

then need further evaluation Usually with CTA imaging If normal physical exam & ABI>0.9, then need further evaluation Usually with CTA imaging If normal physical exam & ABI>0.9,

Documentation/Coding 64

Documentation/Coding Seizures Psychiatric Wellness 64

Broome Docs

DECEMBER 22, 2024

This month we cover a few out-of-hospital arrest trials. Restrictive vs Liberal Transfusion Strategy in Patients With Acute Brain Injury: The TRAIN Randomized Clinical Trial. A Randomized Trial of Drug Route in Out-of-Hospital Cardiac Arrest. Intraosseous or Intravenous Vascular Access for Out-of-Hospital Cardiac Arrest.

Blood Transfusions 52

Blood Transfusions Hospitals Outcomes Emergency Department 52

Don't Forget the Bubbles

NOVEMBER 18, 2024

Epidemiology in Australia In Australia, the reported prevalence of neonatal hypotension in preterm infants is like that in the UK, with around 20-30% of very low birth weight infants experiencing significant hypotension during their initial hospital stay. Effective management of MAS will often result in the stabilization of blood pressure.

Sepsis 59

Sepsis Shock Hyperthermia / Hypothermia Administration 59

EMDocs

JANUARY 6, 2025

Based on available hospital resources, the patient is treated for septic shock secondary to pneumonia and an infected wound using broad-spectrum antibiotics and IV crystalloid fluids. A whole blood transfusion is initiated for the management of her anemia. Hypoglycemia is managed with IV dextrose. Nat Rev Dis Primer.

Infectious Diseases 75

Infectious Diseases CDC PPE Rapid Diagnostic Testing 75