The Trauma Pro

MAY 10, 2024

And its correlation with outcomes varies. The most important one is that it relies only on the Injury Severity Score (ISS) to judge whether some type of mistriage occurred. The ISS is usually calculated after discharge, so it can only be applied after the fact. What is NFTI, Exactly? They reviewed 2.5

Blood Transfusions 147

Blood Transfusions Documentation/Coding Radiology Radiology 147

RebelEM

OCTOBER 30, 2023

This could dilute any beneficial effects seen Lack of blinding may bias results (Although mortality is a solid objective primary outcome, bias may still creep in terms of management) Discussion: Authors were looking for an absolute mortality difference of 7% from baseline mortality of 26% with a 90% power. Cryoprecipitate Group: 25.3%

Administration 112

Administration Blood Transfusions Outcomes Hospitals 112

RebelEM

JUNE 19, 2023

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 99

Outcomes Blood Transfusions Administration Hyperthermia / Hypothermia 99

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. Thromboelastometry (e.g., The balloon generally required 30 minutes to insert.

Operations 98

Operations Blood Transfusions Resuscitation Infectious Diseases 98

Don't Forget the Bubbles

JANUARY 1, 2024

Outcomes From a Randomized Clinical Trial. Two-Year Autism Risk Screening and 3-Year Developmental Outcomes in Very Preterm Infants. Hemoglobin Threshold for Blood Transfusion in Young Children Hospitalized with Iron Deficiency Anemia. Cannabis Exposure and Adverse Pregnancy Outcomes Related to Placental Function.

Pediatrics 98

Pediatrics Ultrasounds Blood Transfusions Sepsis 98

EMDocs

JULY 3, 2023

Introduction SAH has the potential for rapid progression and devastating outcomes. Hematoma expansion Reducing blood pressure to a level that limits bleeding but maintains perfusion is critical to limit hematoma expansion, especially in spontaneous SAH. Short- and long-term outcome of patients with aneurysmal subarachnoid hemorrhage.

Seizures 83

Seizures Stroke Outcomes EMS 83

Don't Forget the Bubbles

NOVEMBER 27, 2023

Either is reasonable as first-line, and there are not currently any studies which directly compare outcomes against each other for children with septic shock. 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 143

Shock Sepsis Fluid Resuscitation Resuscitation 143

Downeast Emergency Medicine

APRIL 26, 2021

4] We also know that severe TBI is commonly associated with the development of intracranial hemorrhage where the presence and volume of blood are associated with increased mortality and poor outcomes.[5] Association between prehospital tranexamic acid administration and outcomes of severe traumatic brain injury. JAMA Neurol.

Head Injuries 52

Head Injuries Administration Outcomes Seizures 52

RebelEM

FEBRUARY 22, 2024

Background : Concurrent anemia worsens outcomes in patients that present with acute myocardial infarctions. Transfusions increase the oxygen carrying capacity of blood which can improve the perfusion of at-risk cardiac tissue. An optimal transfusion hemoglobin cutoff has not yet been established in these patients.

Blood Transfusions 57

Blood Transfusions Outcomes Wellness Research 57

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. NEJM 1994. [2]

Resuscitation 145

Resuscitation Fluid Resuscitation Head Injuries Shock 145

PulmCCM

MAY 8, 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%).

Stroke 52

Stroke Blood Transfusions Hospice Anaphylaxis 52

Emergency Medicine Journal

MAY 23, 2023

Demographic and medical data needed to calculate GBS and CANUKA were collected, as well as outcomes data. Need for intervention was defined as the need for blood transfusion, endoscopic haemostasis or rebleeding within 7 days. In-hospital mortality was also collected.

Emergency Department 40

Emergency Department Blood Transfusions Hospitals Wellness 40

EMDocs

MARCH 6, 2024

There is no clear improvement with idarizucimab or andexanet alfa on patient-oriented outcomes. TXA: Several studies have found no benefit in patient-oriented outcomes with TXA in patients with significant lower GI bleeding. Red Blood Cell Transfusion: 2023 AABB International Guidelines. 2023 Nov 21;330(19):1892-1902.

Blood Transfusions 83

Blood Transfusions Outcomes Resuscitation Hospitals 83

Don't Forget the Bubbles

JULY 5, 2023

Furthermore, educating both patients and their families is important in order to achieve good treatment compliance and better clinical outcomes. 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.

Blood Transfusions 126

Blood Transfusions Stroke Dehydration Sepsis 126

EB Medicine

MARCH 1, 2019

Jeff: In terms of initial resuscitation, there is an ever increasing body of literature to support blood transfusion over crystalloid in patients requiring volume expansion in trauma. There are no specific guidelines for transfusion in the setting of blunt cardiac injury, so stick to your standard trauma protocols.

Emergency Department 40

Emergency Department EKG/ECG Operations Fractures 40

RebelEM

SEPTEMBER 26, 2022

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

Resuscitation 52

Resuscitation Blood Transfusions Outcomes Hospitals 52

Taming the SRU

OCTOBER 25, 2023

Ultimately, patients with variceal bleeding require endoscopic variceal ligation (EVL) but it is important to understand what therapies should be initiated promptly in the ED to improve overall outcomes.

Blood Transfusions 87

Blood Transfusions Hospitals Stroke Anaphylaxis 87

The Skeptics' Guide to EM

DECEMBER 17, 2022

Massive Blood Transfusion Following Older Adult Trauma: the Effect of Blood Ratios on Mortality. Case: A […] The post SGEM386: Blood on Blood – Massive Transfusion Protocols in Older Trauma Patients first appeared on The Skeptics Guide to Emergency Medicine. Date: December 16th, 2022 Reference: Hohle et al.

Blood Transfusions 52

Blood Transfusions Fractures EMS Hospitals 52

Northwestern EM Blog

JANUARY 24, 2022

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.

Anaphylaxis 52

Anaphylaxis Shock Sepsis Resuscitation 52

EMDocs

JUNE 3, 2023

Management and outcomes of open pelvic fractures: An update. 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. Lateral compression 2 pelvic fracture. Radiopaedia.org. Published April 18, 2023.

Fractures 54

Fractures Resuscitation Operations EMS 54

Taming the SRU

JUNE 6, 2023

then need further evaluation Usually with CTA imaging If normal physical exam & ABI>0.9,

Documentation/Coding 59

Documentation/Coding Seizures Wellness Psychiatric 59

EB Medicine

OCTOBER 1, 2018

In other trials, vasopressin also appeared to show a potential benefit in those with AKI and sepsis, although the subsequent VANISH trial (perhaps the best name for a clinical trial so far) failed to demonstrate a benefit to vasopressin titration with regard to renal outcomes in septic shock. Jeff : Next we have epinephrine.

Sepsis 40

Sepsis Shock Fluid Resuscitation Hospitals 40