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. Hypotensive resuscitation during active hemorrhage: impact on in-hospital mortality. NEJM 1994. [2] PMID: 12045644 Bickell WH et al. NEJM 1994.

Resuscitation 145

Resuscitation Fluid Resuscitation Head Injuries Shock 145

Don't Forget the Bubbles

JANUARY 10, 2024

Let’s take the humble blood transfusion – used in emergency departments across the globe and playing a key role in critical care. Severe anaemia is a common and life-threatening cause of hospital admission in children in sub-Saharan Africa. 8% die in hospital, with a further 12% dying in the six months following discharge.

Blood Transfusions 78

Blood Transfusions Research Outcomes Hospitals 78

EMDocs

JUNE 22, 2024

The newborn is doing well, but the mother is complaining of shortness of breath and chest pain. A 37-year-old G5P4 at 33 weeks presents to the ED after being brought in by ambulance. She had a precipitous delivery while the ambulance was pulling in. Triage vital signs (VS) include BP 88/45, HR 121, T 97.1, RR 28, SpO2 89% on 6L NC.

EMS 111

EMS Resuscitation Blood Transfusions Seizures 111

RebelEM

JUNE 19, 2023

Primary Results Patients enrolled from 15 emergency medical services at 21 hospitals across 3 countries over 7 years. Demographics were well balanced in the two groups. The study is relatively small (CRASH2 enrolled > 20,000 patients); just 1300 patients from 21 hospitals over 7 years. Protocol violations occurred in 32.7%

Blood Transfusions 105

Blood Transfusions Outcomes Administration Hyperthermia / Hypothermia 105

Emergency Medicine Journal

MAY 23, 2023

A modified GBS (mGBS) and CANUKA score have recently been proposed but have not been well studied. Methods A single-centre retrospective study was performed including patients with suspected UGIB visiting the ED of Saint-Antoine hospital (Paris, France) from January 2016 to December 2018. In-hospital mortality was also collected.

Emergency Department 40

Emergency Department Blood Transfusions Hospitals Wellness 40

Ziqitza HealthCare Ltd

JULY 23, 2023

It provides sufficient oxygen, blood transfusions and other medication that helps the patient to be in a stabilized condition till reaching the hospital. The Current Scenario Despite having state-of-the-art life support systems and devices, a considerable number of deaths occur during the transfer of patients to hospitals.

Ambulance Services 52

Ambulance Services Basic Life Support Blood Transfusions Patient Safety 52

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

Taming the SRU

AUGUST 4, 2024

We discussed some practices to push learners outside of their comfort zone and promote learning, based on their level as well as their goals for the shift.

Dislocations 85

Dislocations Emergency Department Documentation/Coding Burns 85

The Skeptics' Guide to EM

MARCH 10, 2018

Guest Skeptic: Dr. Justin Morgenstern is an emergency physician and the Director of Simulation Education at Markham Stouffville Hospital in Ontario. Justin Morgenstern is an emergency physician and the Director of Simulation Education at Markham Stouffville Hospital in Ontario. AEM March 2018.

Blood Transfusions 40

Blood Transfusions Emergency Department Shock Hospitals 40

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

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

Taming the SRU

SEPTEMBER 16, 2024

In the era of modern medicine, blood transfusions are commonplace, especially in the emergency department. Transfusion reactions are a spectrum of adverse events that can occur with the transfusion of whole blood or any of its components. One of the major risk factors is receiving a blood transfusion in the past.

Blood Transfusions 90

Blood Transfusions Anaphylaxis Emergency Department Sepsis 90

The Trauma Pro

SEPTEMBER 18, 2023

The door-to-prophylaxis time was defined as the time from hospital arrival to the first dose of medication. Severe injury and blood transfusion are already known to be associated with a higher likelihood of VTE. The authors concluded that the door-to-prophylaxis time was significantly associated with increased incidence of VTE.

Blood Transfusions 113

Blood Transfusions Resuscitation Hospitals Wellness 113

RebelEM

FEBRUARY 22, 2024

in liberal) received a blood transfusion (2.3 as well as their primary outcome confidence interval certainly limits the overall confidence in the trial results. Circulation. 2012;126(16):2020-2035. years Female sex 44.3 Baseline hemoglobin 8.6 g/dl Prior myocardial infarction 33.7 Prior heart failure 30.1 Type 1: 41.7

Blood Transfusions 58

Blood Transfusions Outcomes Wellness Research 58

Taming the SRU

OCTOBER 25, 2023

It should be made based on a balance between risk of thromboembolic events vs recurrent bleeding (risk-benefit), as well as cost-benefit. 100U (30-60 min prior), 0.25-0.375/100U

Blood Transfusions 98

Blood Transfusions Stroke Hospitals Anaphylaxis 98

EMDocs

JULY 3, 2023

All patients with concern for SAH need a rapid primary survey to assess the airway, breathing, and circulation as well as a comprehensive neurologic exam to create a baseline for the patient. 27 Prudent transfer of patients to a center with neurosurgical capabilities should be considered in any SAH, though this is not well studied.

Seizures 98

Seizures Stroke Outcomes EMS 98

EMDocs

JUNE 3, 2023

Her Glasgow Coma Scale (GCS) is 14 (3E-5V-6M), and she arrives in a cervical collar placed pre-hospital. 23 Pelvic binding remains a critical resuscitation step well within the purview of the ED physician, and can be reviewed here: [link]. Her airway is intact, and she has equal bilateral breath sounds. J Clin Orthop Trauma.

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. His immunizations are current and has received all pneumococcal vaccinations.

Pediatrics 98

Pediatrics Dehydration EMS Hospitals 98

Don't Forget the Bubbles

JULY 5, 2023

SCD, therefore, is not only a mechanical disease but there are also many other cellular and plasma factors as well as endothelial interaction that generate chronic inflammation. 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.

Blood Transfusions 126

Blood Transfusions Stroke Dehydration Sepsis 126

Don't Forget the Bubbles

JANUARY 1, 2024

The Bubble Wrap Plus is a monthly paediatric Journal Club reading list from Professor Jaan Toelen (University Hospitals Leuven) and Dr Anke Raaijmakers (Sydney Children’s Hospital). However, children who had an operation experienced improvements in behaviour, symptoms, and quality of life and had lower blood pressure.

Pediatrics 98

Pediatrics Ultrasounds Blood Transfusions Sepsis 98

The Trauma Pro

DECEMBER 10, 2024

This didn’t sit well with some, and a multicenter study was launched to look at this group more closely. But what about low-grade isolated spleen injuries with a contrast blush? Apparently, a few authors believe that this may be a benign condition that doesn’t require any specific management.

Blood Transfusions 147

Blood Transfusions Radiology Radiology Emergency Department 147

Don't Forget the Bubbles

FEBRUARY 24, 2025

Two-month-old Isla presents to their local hospital following a prolonged apnoea at home. They were a well-grown, term infant born in good condition. Exchange blood transfusion in the management of severe pertussis in young infants. Exchange transfusion safety and outcomes in neonatal hyperbilirubinemia.

Pediatrics 59

Pediatrics Outcomes Blood Transfusions Sepsis 59

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

Documentation/Coding 64

Documentation/Coding Seizures Psychiatric Wellness 64

RebelEM

DECEMBER 23, 2024

There has been ongoing study about the clinical significance of these effects, as well as whether and for whom LR might provide meaningfully better clinical outcomes ( Myburgh 2013 , Self 2018 , Semler 2018 , Self 2020 ). saline affect hospital-free days by day 30?

Fluid Resuscitation 129

Fluid Resuscitation Resuscitation Documentation/Coding Outcomes 129

Sensible Medicine

NOVEMBER 18, 2023

Do I have to request my blood transfusion be screened for HIV? There is no good evidence that making health care providers who feel well wear flimsy surgical masks lowers iatrogenic spread to patients. My hospital— SFGH— has never stopped masking, and not masking is a misdemeanor offense in SF.

Blood Transfusions 145

Blood Transfusions Hospitals Wellness 145

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. This can manifest as hypotension.

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