Remove Blood Transfusions Remove Outcomes Remove Resuscitation
article thumbnail

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. I recently gave a talk on the initial management of trauma patients with hemorrhagic shock. vs SBP target <90mmHg which resulted in a mortality of 33.4%

article thumbnail

TEG-Guided Resuscitation of Patients with Cirrhosis and Non-Variceal Bleeding

RebelEM

Randomized study design Blind adjudication of transfusion reaction outcomes Follow-up was complete. The primary outcome was disease-oriented The enrolled cohort appears to be a convenience sample Sealed envelopes are a weak type of allocation and prone to error and manipulation. Significant coagulopathy: INR > 1.8

Insiders

Sign Up for our Newsletter

This site is protected by reCAPTCHA and the Google Privacy Policy and Terms of Service apply.

article thumbnail

Best Of AAST #7: How Do You Like Your Platelets – Warm Or Cold?

The Trauma Pro

Until the last few years, massive transfusion in trauma consisted of component therapy, an admixture of packed red cells, plasma, and platelets. Whole blood transfusion is making inroads again, but it is used in a minority of centers. They identified soldiers who received either room-temperature or cold-stored platelets.

Military 113
article thumbnail

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

RebelEM

PMID: 37314244 Clinical Question: In advanced trauma systems, does prehospital administration of TXA increase the rate of survival with a favorable neurologic outcome in patients at risk for trauma-induced coagulopathy? 1.00 (0.9 – 1.12) Secondary Outcome Mortality 24h 9.7% Prehospital Tranexamic Acid for Severe Trauma.

Outcomes 105
article thumbnail

emDOCs Podcast – Episode 102: Hypocalcemia in Trauma and the Diamond of Death

EMDocs

HypoCa is common in trauma patients and is associated with poor outcomes. A meta-analysis found that 56% of patients with severe trauma resulting in hypotension have hypoCa.There was an increase in mortality, increased need for transfusion, and increased risk of coagulopathy in patients with hypoCa. Am J Emerg Med. 2021 Mar;41:104-109.

article thumbnail

emDOCs Podcast – Episode 100: Acute Chest Syndrome Part 1

EMDocs

Fluid management Goal is euvolemia Dehydration – needs IV fluid resuscitation. Simple blood transfusion should be considered early in the hypoxemic patient with advancement to red cell exchange transfusion if there are clinical features of severe pathology or evidence of progression despite initial simple transfusion.

article thumbnail

emDOCs Podcast – Episode 101: Acute Chest Syndrome Part 2

EMDocs

Fluid management Goal is euvolemia Dehydration – needs IV fluid resuscitation. Blood transfusion Reduces the overall proportion of HbS. Causes and outcomes of the acute chest syndrome in sickle cell disease. Decreases splinting and improves tidal volumes. If euvolemic – start maintenance fluids of D5 in 0.45%NS