Don't Forget the Bubbles

JANUARY 1, 2024

Hemoglobin Threshold for Blood Transfusion in Young Children Hospitalized with Iron Deficiency Anemia. Late surfactant administration after 48 hours of age in preterm neonates with respiratory insufficiency: a systematic review and meta-analysis. Lo Vecchio A, et al.J 2023 Dec 20:113876. Rose Sun DL, et al. Van Vyve L, et al.

Pediatrics 98

Pediatrics Ultrasounds Blood Transfusions Sepsis 98

Downeast Emergency Medicine

APRIL 26, 2021

2][3] If earlier treatment with TXA is better, would there be benefit in its administration in the prehospital setting? Association between prehospital tranexamic acid administration and outcomes of severe traumatic brain injury. Blood Coagul Fibrinolysis. If so, could this be done safely? JAMA Neurol. 2021;78(3):338–345.

Head Injuries 52

Head Injuries Administration Outcomes Seizures 52

RebelEM

MAY 25, 2023

vs 3U) but no difference in mortality (Study not powered for this outcome) Clinical Take Home Point: The use of vasopressors is controversial and requires a nuanced approach SUMMARY OF MINIMIZING IATROGENIC INJURY RESTORE PERFUSION VOLUME REPLACEMENT Blood Products >>> Crystalloids Holcomb JB et al. Intensive Care Med 2020. [13]

Resuscitation 145

Resuscitation Fluid Resuscitation Head Injuries Shock 145

Pediatric EM Morsels

NOVEMBER 3, 2023

Food and Drug Administration Approval of Artesunate for Severe Malaria: Enough to Achieve Best Practice? Imported Malaria in Countries where Malaria Is Not Endemic: a Comparison of Semi-immune and Nonimmune Travelers. Clin Microbiol Rev. 2020 Mar 11;33(2):e00104-19. PMID: 32161068 Thomas CM, Stauffer WM, Alpern JD. Clin Infect Dis.

Seizures 245

Seizures Pediatrics CDC Infectious Diseases 245

PulmCCM

NOVEMBER 17, 2023

shows blood administration with a direct linear relationship between Pra and CO/VR; only Pmsf is varied here. In the second thought experiment, let us consider a patient with significant blood volume loss that is replenished with a series of blood transfusions. OP is operating point. See text for details.

Operations 132

Operations Ultrasounds Resuscitation Blood Transfusions 132

PHEM Cast

NOVEMBER 28, 2022

Here are some links to the excellent Life in the Fast Lane: [link] [link] Acute Coagulopathy of Trauma Tranexamic Acid The Resus Room podcast which discusses Tim and colleagues paper on gender differences in TXA administration is available here: [link] Want to read more about Crash 4? Cochrane Database of Systematic Reviews 2011, Issue 3.

Blood Transfusions 52

Blood Transfusions Administration Research 52

Don't Forget the Bubbles

JULY 5, 2023

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. In these cases, repeat the Hb electrophoresis three months after the last blood transfusion. Would you consider this patient for blood transfusion?

Blood Transfusions 126

Blood Transfusions Stroke Dehydration Sepsis 126

Northwestern EM Blog

JANUARY 24, 2022

At those levels, bicarbonate administration has not been shown to improve cardiac output, MAP or pressor response. For example, a patient in cardiogenic shock will likely worsen with the administration of fluids and the wrong vasopressors. A loading dose of 100mg IV should be given, followed by 50mg every 6 hours thereafter.

Anaphylaxis 52

Anaphylaxis Shock Sepsis Resuscitation 52

Taming the SRU

OCTOBER 25, 2023

100U (30-60 min prior), 0.25-0.375/100U

Blood Transfusions 87

Blood Transfusions Hospitals Stroke Anaphylaxis 87

EMDocs

JUNE 3, 2023

Early administration of antibiotics may not be prioritized in the setting of hemodynamic instability but antibiotics are a critical portion of management if open fracture is suspected. 12 An AP x-ray of the pelvis should be obtained in the ED for unstable patients. 2021;52(10):2697-2701. doi:10.1016/j.injury.2020.01.042 2010;376(9734):23-32.

Fractures 54

Fractures Resuscitation Operations EMS 54

Taming the SRU

MAY 30, 2023

mg single-dose 5-mL ampule or equivalent, 2 Aspirin, 325-mg tablets, 4 Bronchodilator, metered-dose inhaler or equivalent 50% Dextrose injection, single-dose 50-mL ampule or equivalent Epinephrine injection, 1:1000 (1 mg/mL) single-dose 1-mL ampule or equivalent, 2 Epinephrine injection, 1:10,000 (0.1

OB/GYN 52

OB/GYN Ultrasounds Pediatrics Resuscitation 52

Taming the SRU

JUNE 6, 2023

Disposition Indications for admission GCS<15, focal neurological deficits, seizures Intractable vomiting Significant Abnormal CT results Discharge criteria Normal GCS, exam Caregiver at home Certain abnormal CT Isolated & non-depressed calvarial skull fractures <1cm diameter of solitary cerebral contusions <1cm width of epidural or (..)

Documentation/Coding 59

Documentation/Coding Seizures Wellness Psychiatric 59

EB Medicine

OCTOBER 1, 2018

Current guidelines recommend that broad spectrum antibiotics be administered within the first hour of presentation for those with sepsis or septic shock, ideally with blood cultures being drawn beforehand. In one study, every hour of delayed abx administration was associated with an 8% increase in mortality.

Sepsis 40

Sepsis Shock Fluid Resuscitation Hospitals 40