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. shock, a bleeding visible vessel, renal disease, or lack of consent. TXA is a synthetic derivative of lysine that inhibits fibrinolysis and thus stabilizing clots that are formed.

Blood Transfusions 40

Blood Transfusions Emergency Department Shock Hospitals 40

Downeast Emergency Medicine

APRIL 26, 2021

When looking at the subgroups with severe shock, there was an 18.5% When stratifying TXA administration time after injury and qualifying shock incidence, there appeared to be a lower 30 d mortality if TXA was given within 1 hour of the incident. MI or stroke). DOES TXA IMPROVE OUTCOMES IN PATIENTS WITH TBI? Arch Surg 2012; 147:113-119.[

Head Injuries 52

Head Injuries Administration Outcomes Seizures 52

Pediatric EM Morsels

NOVEMBER 3, 2023

This is otherwise known as Blackwater fever (Forgie 2022) Severe Malaria laboratory findings include acute kidney injury , hyperbilirubinemia , hemoglobinuria , severe anemia, hypoglycemia, lactic acidosis , and hyperparasitemia (Forgie 2022) Severe Malaria is almost entirely attributed to infection with P.

Seizures 245

Seizures Pediatrics CDC Infectious Diseases 245

Northwestern EM Blog

JANUARY 24, 2022

Written by: Elizabeth Stulpin, MD (NUEM ‘23) Edited by: Aaron Wibberly, MD (NUEM ‘22) Expert Commentary by : Joshua Zimmerman, MD (NUEM ‘17) Non-Response to Vasopressors Shock is defined as a state of cellular and tissue hypoxia resulting in end organ dysfunction. And for most forms, EM physicians are not typically shocked by shock.

Anaphylaxis 52

Anaphylaxis Shock Sepsis Resuscitation 52

PulmCCM

NOVEMBER 17, 2023

In the second thought experiment, let us consider a patient with significant blood volume loss that is replenished with a series of blood transfusions. Shippy CR, Appel PL, Shoemaker WC: Reliability of clinical monitoring to assess blood volume in critically ill patients. Am J Cardiol 1990, 66(4):493-496.

Operations 132

Operations Ultrasounds Resuscitation Blood Transfusions 132

EB Medicine

MARCH 1, 2019

Consider valvular injury in any patient who appears to be in cardiogenic shock, has hypotension without obvious hemorrhage, or has pulmonary edema. In those with severe injury, you may note refractory hypotension secondary to cardiogenic shock. The latter also recommend ED thoracotomy in those with refractory shock.

Emergency Department 40

Emergency Department EKG/ECG Operations Fractures 40

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

EB Medicine

OCTOBER 1, 2018

This month, we’ll be talking Updates and Controversies in the Early Management of Sepsis and Septic Shock. And sepsis-3 redefined septic shock as “hypotension not responsive to fluid resuscitation” with the added requirement of vasopressors to maintain a MAP greater than or equal to 65 and with a lactate > 2. That’s where we’re at.

Sepsis 40

Sepsis Shock Fluid Resuscitation Hospitals 40

Taming the SRU

OCTOBER 25, 2023

Oakland Score Designed to be evaluated in the ED for patients presenting with LGIB to determine if outpatient management is feasible Factors included for assessment: Age, sex, previous LGIB admission, DRE findings, HR, SBP, Hb Score of 8 or less → 95% probability of safe discharge Safe discharge = absence of rebleeding, blood transfusion, therapeutic (..)

Blood Transfusions 87

Blood Transfusions Hospitals Stroke Anaphylaxis 87

EMDocs

MARCH 6, 2024

shock index > 1, evidence of poor systemic perfusion). Red Blood Cell Transfusion: 2023 AABB International Guidelines. Restrictive versus liberal blood transfusion for gastrointestinal bleeding: A systematic review and meta-analysis of randomised controlled trials. 2023 Nov 21;330(19):1892-1902.

Blood Transfusions 83

Blood Transfusions Outcomes Resuscitation Hospitals 83

RebelEM

SEPTEMBER 26, 2022

Thromboelastography-guided transfusion decreases intraoperative blood transfusion during orthotopic liver transplantation: a randomized clinical trial. Significant coagulopathy: INR > 1.8 CONSORT 2010 statement: updated guidelines for reporting parallel group randomized trials. Ann Intern Med. 2010;152(11):726-732.

Resuscitation 52

Resuscitation Blood Transfusions Outcomes Hospitals 52

EMDocs

JUNE 3, 2023

4 Patients with pelvic fractures are considered unstable when systolic blood pressure < 90mmHg and heart rate >120bpm, or in those with dyspnea, altered mental status, or skin findings of shock. 2021;52(10):2697-2701. doi:10.1016/j.injury.2020.01.042 2020.01.042 CRASH-2 trial collaborators, Shakur H, Roberts I, et al.

Fractures 54

Fractures Resuscitation Operations EMS 54

Taming the SRU

JUNE 6, 2023

mg/kg of IBW Seek to match a patient's minute ventilation with TV and RR after intubation Intentionally match patient's intrinsic RR noted prior to intubation Note that healthy lungs can handle 8 mL/kg, based on IBW, if that is useful for compensation Secure your ETT Thomas Tube Holder is a new ETT holder on Air Care for ETT down to size 6.5

Documentation/Coding 59

Documentation/Coding Seizures Wellness Psychiatric 59