PEMBlog

APRIL 24, 2024

Retrospective use has been shown to be valid and reliable in one cross-sectional study ( Beslow 2012 ).This Early consultation with a pediatric hematologist and neurologist is mandatory. References / Key Articles Ichord RN, Bastian R, Abraham L, et al.

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Stroke Pediatrics Blood Transfusions Radiology 59

Don't Forget the Bubbles

JANUARY 10, 2024

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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Blood Transfusions Outcomes Research Hospitals 78

University of Maryland Department of Emergency Med

AUGUST 18, 2023

In this small propensity matching study looking at prehospital blood transfusion vs. emergency department blood transfusion in trauma patients ag. Click to view the rest

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Blood Transfusions Pediatrics Emergency Department 40

The Trauma Pro

MAY 26, 2023

Possible interventions were none, operation, angioembolization, or blood transfusion. They examined how often serial hemoglobin determinations influenced management during the study period. That patient had a laparotomy based on the lab test.

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Blood Transfusions Operations Pediatrics Hospitals 130

PulmCCM

OCTOBER 3, 2023

Among 324 patients with trauma and life-threatening bleeding at 12 French hospitals who were randomized to receive 1ml/kg PCC or placebo, there was no reduction observed in 24-hour blood transfusion needs in the PCC group. PCC was associated with a significantly higher risk for thromboembolic complications (35% vs 24%). Read in JAMA

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The Trauma Pro

OCTOBER 10, 2023

This can result in catastrophic errors if test results are misinterpreted, or a blood transfusion with incorrect ABO typing is given to the wrong patient. There are too many opportunities to mix up similar names, especially if the last one is always the same. Some use number and letter sequences combined with another unique word.

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Blood Transfusions Best Practices Hospitals Wellness 113

The Trauma Pro

SEPTEMBER 20, 2023

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.

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Military Blood Transfusions Outcomes Administration 113

Sensible Medicine

NOVEMBER 27, 2023

But, on the other hand, giving blood comes with the risk of volume overload, infection, clotting and inflammation. But, in general, blood transfusion strategies have been studied in many other clinical situations. Previous trials of treating anemia in post-MI patients have been small and inconclusive.

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Blood Transfusions Outcomes Hospitals 98

Intensive Blog

AUGUST 17, 2023

What is an appropriate “trigger threshold” for blood transfusion in ECMO patients? Blood transfusion is common in ECMO patients, as evidenced by almost 90% of all patients receiving at least one packed red blood cell transfusion during VV-ECMO support (Kalbhenn and Zieger, 2022). 2020.08.068.

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ALiEM

MAY 29, 2023

Because he presumably had uremia-induced thrombasthenia (weak platelets), he received blood transfusions and IV TXA. We thus removed the anterior packing and instead inserted a Foley catheter into the posterior nasal space and inflated the balloon. Unfortunately, the bleeding still continued.

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Blood Transfusions Emergency Department Shock Hospitals 98

RebelEM

FEBRUARY 1, 2024

What they Did : Investigator-initiated, Multicenter, Parallel-ground, Open-label, Registry-linked, Randomized, Controlled, Non-Inferiority trial 22 Canadian Primary and Comprehensive Stroke Centers from December 2019 to January 2022 Eligible ischemic stroke patients randomized 1:1 to receive intravenous tenecteplase (0.25 mg/kg followed by 0.81

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Stroke Blood Transfusions Outcomes EMS 121

ALiEM

NOVEMBER 3, 2023

Highlighted Quality Posts: Trauma Site Article Author Date Label Rebel EM Trauma Resuscitation Update Salim Rezaie, MD May 25, 2023 AIR EM Docs Unstable Pelvic Trauma Patient Luke Wohlford, MD June 3, 2023 AIR EM Docs Maxillofacial Trauma Forrest Turner, MD October 17, 2022 AIR Rebel EM PATCH trauma trial Anand Swaminathan, MD June 19, 2023 HM Don’t (..)

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Blood Transfusions EMS Emergency Department Resuscitation 83

Don't Forget the Bubbles

MAY 8, 2023

Most require no regular treatment, but some may require either occasional or regular blood transfusions. Regular transfusions may ease symptoms but carry the risk of iron overload, resulting in a need for chelation therapy and ongoing monitoring with serum ferritin and Ferriscan imaging.

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Blood Transfusions 52

ACEP Now

MAY 3, 2023

Management requires hospitalization for hydration, oxygenation, intravenous antibiotics, pain control, and blood transfusions and, in some cases, exchange transfusion. See the original question here.) Member Benefit: All ACEP members receive a 20 percent discount on VisualDX. Reference Winter MW, Ingerowski E, Prasad P.

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Blood Transfusions Hospitals 52

EMergucate

MAY 17, 2016

Anaemia Anticoagulants Bleeding Disorders Blood Transfusion Reactions Blood Transfusions DIC Haemoglobinopathies Haemostasis & Coagulation Methaemoglobinaemia Neutropaenia Platelet Disorders Thrombophilia

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EMergucate

AUGUST 23, 2017

An 80 year old women with severe anaemia secondary to GI bleed Severe anaemia requiring urgent blood transfusion, correction of … Continue reading →

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Blood Transfusions Resuscitation EMS 40

Emergency Medicine Cases

JUNE 27, 2017

Dr. Lloyd reviews how to avoid needless blood transfusions, the indications for IV iron and how to actually administer IV iron, while Dr. Clarridge reviews a novel approach, causes, complications and management of hyponatremia in the ED.

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American Medical Compliance

SEPTEMBER 10, 2023

” What you will learn: Definition of informed consent Issues of concern related to informed consent Informed consent and blood transfusions Informed consent in healthcare When informed consent is necessary How to obtain informed consent Details Course length: 30 minutes; CEU: 0.5

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Blood Transfusions Documentation/Coding Operations 52

RebelEM

OCTOBER 30, 2023

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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Administration Blood Transfusions Outcomes Hospitals 114

Dr. Smith's ECG Blog

JULY 3, 2020

The patient was in shock on arrival in the ED — and multiple blood transfusions were needed. ANSWERS regarding ECG #1: Severe trauma requiring blood transfusions is a common emergency presentation. Blood and fluid volume was rapidly restored, and acidosis was probably quickly corrected. WHY is the QRS complex wide?

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Blood Transfusions EKG/ECG Shock Fractures 52

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. Basic life support The BLS ambulances of Ambulance on Call are designed in such a way that it provides enhanced medical assistance to their clients during transportation.

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Ambulance Services Basic Life Support Blood Transfusions Patient Safety 52

RebelEM

JUNE 19, 2023

Effects of tranexamic acid on death, vascular occlusive events, and blood transfusion in trauma patients with significant haemorrhage (CRASH-2): A randomised, placebo-controlled trial. Read More Core EM: CRASH-2: Tranexamic Acid in Major Trauma References: CRASH-2 Trial Collaborators. Lancet 2010; 376(9734): 23-32.

Outcomes 100

Outcomes Blood Transfusions Administration Hyperthermia / Hypothermia 100

RebelEM

OCTOBER 19, 2022

Hayes 2013 ) Disposition: Admission to monitored setting if ongoing intravenous repletion (bradycardia and hypertension may occur) Consider giving prophylactic calcium supplementation in patients receiving massive transfusions. mg/dL or an ionized calcium level < 2.0 mEq/L Background Exists in two states Free ionized form (approx.

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EKG/ECG Blood Transfusions Burns EMS 52

PulmCCM

NOVEMBER 6, 2023

Uncertainty has persisted about the ideal blood transfusion strategy to resuscitate and support trauma victims as they are prepared to undergo surgical and other mechanical interventions to achieve hemostasis.

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Operations Blood Transfusions Resuscitation Infectious Diseases 98

EMDocs

AUGUST 22, 2023

Trauma Associated with severity of injury and need for blood transfusion ↓ EtCO 2 = ↑ likelihood of needing OR EtCO 2 < 25 mm Hg =↓ cardiac output, ↓ BP & ↑ mortality Fluid responsiveness 2 mmHg ↑ EtCO 2 with straight leg raise = patient will be fluid responsive DKA ↓ EtCO 2 levels = ↑likelihood of diagnosis.

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Emergency Department Blood Transfusions Resuscitation Sepsis 65

Emergency Medicine Ireland

OCTOBER 17, 2022

An intensive care unit admission is bad for cancer as there is a sort of immunosupression that comes about with being critically ill, leading to depletion in things like natural killer cells who were rightfully killing off cancer cells till the pneumonia, steroids and blood transfusions came along.

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Blood Transfusions Sepsis 40

Don't Forget the Bubbles

JANUARY 1, 2024

Hemoglobin Threshold for Blood Transfusion in Young Children Hospitalized with Iron Deficiency Anemia. High Cardiac Troponin Levels in Infants with Acute SARS-CoV-2 Infection: A Prospective Comparative study. Lo Vecchio A, et al.J 2023 Dec 20:113876. Rose Sun DL, et al.

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Pediatrics Ultrasounds Blood Transfusions Sepsis 98

PHEM Cast

FEBRUARY 23, 2017

.: Prehospital transfusion of plasma and red blood cells in trauma patients. Weaver AE, Eshelby S, Norton J, Lockey DJ: The introduction of on-scene blood transfusion in a civilian physician-led pre-hospital trauma service. Prehosp Emerg Care 19(1):1–9, 2015. Scand J Trauma Resusc Emerg Med 21(Suppl1):S27, 2013.

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Blood Transfusions Head Injuries Resuscitation Radiology 52

Taming the SRU

APRIL 3, 2023

Cardiac Arrest in Pregnancy 1 in 30,000 pregnancies 800 maternal deaths globally Rates have nearly doubled between 1989 and 2009 Survival to hospital discharge after maternal in-hospital cardiac arrest 58.9%

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Blood Transfusions Fluid Resuscitation Resuscitation Stroke 40

Don't Forget the Bubbles

NOVEMBER 27, 2023

The citrate in blood products can also bind to calcium and cause a drop in calcium levels, so do anticipate this for any children requiring blood transfusion. Shock and sepsis itself can cause low calcium levels due to intracellular shifts and lactate-binding calcium.

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Shock Sepsis Fluid Resuscitation Resuscitation 143

The Skeptics' Guide to EM

MARCH 10, 2018

TXA has been widely used in elective surgical cases and has shown decreased need for blood transfusion and reduction in mortality. TXA is a synthetic derivative of lysine that inhibits fibrinolysis and thus stabilizing clots that are formed. It made sense to look at it for the treatment of epistaxis.

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Blood Transfusions Emergency Department Shock Hospitals 40

RebelEM

FEBRUARY 22, 2024

in liberal) received a blood transfusion (2.3 Liberal versus restrictive transfusion thresholds for patients with symptomatic coronary artery disease. Third universal definition of myocardial infarction. Circulation. 2012;126(16):2020-2035. years Female sex 44.3 Baseline hemoglobin 8.6 g/dl Prior myocardial infarction 33.7

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Blood Transfusions Outcomes Wellness Research 57

The Trauma Pro

SEPTEMBER 18, 2023

Severe injury and blood transfusion are already known to be associated with a higher likelihood of VTE. The fact that the longer door-to-prophylaxis group had more frequent VTE may very well be due to their higher ISS and greater number of transfusions. And the authors remind us that this study shows association, not causation.

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Blood Transfusions Resuscitation Hospitals Wellness 147

RCEM Learning

NOVEMBER 28, 2022

If bleeding is suspected, give IV tranexemic acid 1g bolus followed by infusion if within 3 hours of injury and activate your local Major Haemorrhage Protocol for an unstable patient requiring blood transfusion Analgesia: IV morphine first line/ IN diamorphine or ketamine (4) Cross match blood along with organising other laboratory blood tests (VBG, (..)

Fractures 52

Fractures Blood Transfusions Sepsis Operations 52

American Medical Compliance

JANUARY 23, 2024

The following Comprehensive Blood Administration Training is designed to educate healthcare providers on various blood products. Also, a variety of healthcare professionals handle blood products. The post Comprehensive Blood Administration Training appeared first on American Medical Compliance.

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Administration Blood Transfusions Infectious Diseases Documentation/Coding 52

EMDocs

JULY 3, 2023

Blood Transfus. Curr Neurol Neurosci Reports. 2018;18(10):71.  2018;18(10):71. Zanon E, Pasca S. Intracranial haemorrhage in children and adults with haemophilia A and B: a literature review of the last 20 years. 2019 Sep;17(5):378-384. Dubosh NM, Bellolio MF, Rabinstein AA, et al.

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Seizures Stroke Outcomes EMS 81

RebelEM

MAY 25, 2023

The Role of Whole Blood Transfusions in Civilian Trauma: A Review of Literature in Military and Civilian Trauma. Effects of tranexamic acid on death, vascular occlusive events, and blood transfusion in trauma patients with significant haemorrhage (CRASH-2): a randomised, placebo-controlled trial. Cureus 2022.

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