Remove Blood Transfusions Remove Hyperthermia / Hypothermia Remove Outcomes
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emDOCs Podcast – Episode 102: Hypocalcemia in Trauma and the Diamond of Death

EMDocs

Previous triad of death = hypothermia, acidosis, and coagulopathy. HypoCa is common in trauma patients and is associated with poor outcomes. Whole blood does contain less citrate. Liver dysfunction, secondary cirrhosis, critical illness, trauma, and hypothermia reduce citrate metabolism. Hypothermia also leads to hypoCa.

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Are we on the right TRACT? 

Don't Forget the Bubbles

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.

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Rethinking the Role of TXA: Are We Asking Too Much?

RebelEM

Our bodies have a finely tuned system that allows blood to flow freely and not clot too easily while also allowing the body to form clots when needed. This balance is upset in trauma by loss of blood and factors, acidosis, hypothermia and the inflammatory cascade. 1.00 (0.9 – 1.12) Secondary Outcome Mortality 24h 9.7%

Outcomes 105
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emDOCs Podcast – Episode 101: Acute Chest Syndrome Part 2

EMDocs

Blood transfusion Reduces the overall proportion of HbS. Issues with pulse oximetry Pulse oximetry frequently underestimates the alveolar hypoxia that results in sickling and pulmonary infarction and overestimates the arterial blood oxygen saturation. Causes and outcomes of the acute chest syndrome in sickle cell disease.

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Neonatal Hypotension

Don't Forget the Bubbles

Research and guidelines from Australian centres, like those published by the Australian and New Zealand Neonatal Network (ANZNN), emphasize early detection and management to improve outcomes. Effective management of MAS will often result in the stabilization of blood pressure. After any stressful situation, don’t forget to debrief.

Sepsis 59
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emDOCs Revamp – Acute Chest Syndrome

EMDocs

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. Pediatr Blood Cancer. Triage vital signs include BP 127/81, HR 119, T 102.9

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Vasopressor Nonresponse

Northwestern EM Blog

Those at higher risk of hypocalcemia (vitamin D deficiency, ESRD, hyperparathyroidism, burns, multiple blood transfusions, etc.) However, even subclinical hypothyroidism with an elevated TSH but normal T4 increases risk of poor outcomes due to effects on cardiac function. Sources: 1) Amrein K, Martucci G, and Hahner S.