Don't Forget the Bubbles

JUNE 30, 2023

This was a randomised controlled multisite study comparing resuscitation of trauma patients requiring massive transfusion using either 1:1::1 or 1:1:2 ratios of platelets to plasma to red blood cells. Pragmatic Randomized Optimal Platelet and Plasma Ratios (PROPPR) Trial: design, rationale and implementation. to −0.5%]; P  = 0.03.).

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AAEM RSA

APRIL 1, 2021

1 The American College of Surgeons’ (ACS) Trauma Quality Improvement Program (TQIP) Massive Transfusion in Trauma Guidelines leave a good amount of flexibility for hospitals regarding transfusion protocols, focusing more on systems-level aspects of designing and implementing MTPs.2,3 ACS TQIP Best Practice Guidelines. 248(3):447-58.

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The Curious Clinicians

JANUARY 16, 2024

One well-known study bled volunteers to a hemoglobin of 5 g/dL, while keeping them isovolemic with albumin or plasma infusions. The subjects’ blood was less viscous than normal, due to the isovolemic replenishment with plasma and albumin, making it flow more easily. A patient with hemorrhagic shock has problems with both.

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ACEP Now

FEBRUARY 11, 2025

Investigation of the adrenergic and opioid binding affinities, metabolic stability, plasma protein binding properties, and functional effects of selected indole-based kratom alkaloids. Kruegel AC, Gassaway MM, Kapoor A, et al. Gold MS, Pottash AC. Obeng S, Kamble SH, Reeves ME, et al. J Med Chem. 2020;63(1):433-439.

NARCAN 89

NARCAN Naloxone Overdose Mental Health Services 89

EMDocs

JUNE 14, 2023

doi:10.1080/10773525.2015.1123848 Povey AC, Rees HG, Thompson JP, Watkins G, Stocks SJ, Karalliedde L. Two assays available used to help confirm diagnosis, however, do not guide treatment Low levels of activity are consistent with organophosphate poisoning. 3 However, may be helpful in diagnosing the chronic toxicity forms. 2016;22(1):68-79.

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Dr. Smith's ECG Blog

FEBRUARY 6, 2025

Whenever I see PVCs with the morphology and axis seen in todays case I always look for signs of AC ( Arrhythmogenic Cardiomyopathy ). See this case for an in-depth discussion of AC and an example of VT and ECG changes associated with this disorder. The minimum effective plasma concentration of flecainide is about 200 ng/mL.

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EMDocs

JUNE 7, 2023

8 Plasma butyrylcholinesterase (“pseudocholinesterase”) activity Easier to assay and is more widely available Red cell acetylcholinesterase (“true cholinesterase”) activity More accurate and specific Management: Patients require immediate intervention if there is concern for acute organophosphate poisoning. Toxicology. 2001;160(1-3):27-33.

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EMDocs

MAY 17, 2025

10 g/dL in patients with acute coronary syndrome (ACS). Balanced transfusion of packed red blood cells (PRBCs), platelets and fresh frozen plasma (FFP) in a 1:1:1 ratio is the current best practice to avoid inducing coagulopathy by large volume blood product administration.

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EMDocs

JULY 19, 2023

7 We are commonly taught that metals are not amenable to treatment with activated charcoal (AC).However, In short, there is not a whole lot of evidence to support this, but if patient has had a recent ingestion and is not altered, you can consider gastrointestinal decontamination with AC.

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Don't Forget the Bubbles

JULY 5, 2023

SCD, therefore, is not only a mechanical disease but there are also many other cellular and plasma factors as well as endothelial interaction that generate chronic inflammation. Opioids do not cause ACS but they can exacerbate hypoxia in patients with ACS. Morphine sulphate is the commonest strong opioid to start with.

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EMDocs

JANUARY 6, 2025

link] Hummell AC, Cummings M. GI symptoms, right upper quadrant abdominal pain, jaundice. ^ = AMB, a region of sub-Saharan Africa consisting of > 20 countries which have an unusually high incidence of bacterial meningitis and frequency of outbreaks; nearly half of global bacterial meningitis cases occur in the AMB. Accessed June 11, 2023.

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