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Imported Malaria

Pediatric EM Morsels

This allowed US hospitals to stock the drug to ensure quick treatment of suspected severe cases, rather than having to ship it from the CDC under the prior expanded-access protocol (Thomas 2023). Higher Rates of Misdiagnosis in Pediatric Patients versus Adults Hospitalized with Imported Malaria. Third times the charm! June 28, 2023.

Seizures 278
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What’s With Those John / Jane Doe Names?

The Trauma Pro

To expedite care, most hospitals developed a system of pseudo-names to be used until the patient can be identified. The use of Doe names in electronic health records is rapidly fading as well. The best practice for this varies by electronic record system and hospital. Originally, these names were often “Doe” names.

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Sickle Cell Disease Module

Don't Forget the Bubbles

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.

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The End Of Serial Hemoglobin/Hematocrit In Solid Organ Injury

The Trauma Pro

We developed our first iteration of a solid organ injury practice guideline at Regions Hospital way back in 2002. Possible interventions were none, operation, angioembolization, or blood transfusion. Here’s the final post on my series covering serial hemoglobin testing in the management of solid organ injury.

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Are we on the right TRACT? 

Don't Forget the Bubbles

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.

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CRYOSTAT-2: Early Empiric Cryoprecipitate in Major Trauma

RebelEM

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.

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Trauma Resuscitation Updates

RebelEM

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.