REBEL EM

SEPTEMBER 13, 2023

Bradykinin Mediated Plasma globulins called kininogens release bradykinin and cause vascular permeability. Image: ( Morgan 2010 ) Features Absence of urticaria and pruritus Insidious onset (24-36 hours) ACE Inhibitors Inhibition of ACE hinders the degradation of bradykinin and can lead to idiosyncratic angioedema.

Frozen Plasma 99

Frozen Plasma Allergic Reaction FFP Plasma 99

Emergency Medicine Cases

FEBRUARY 9, 2021

Until the results of lab testing come back and hemorrhage pace is slowed, what ratio of plasma to RBCs should we target? If someone is on anti-platelets or anticoagulants what is the best strategy to ensure the docs in the ED know what to give and how much? What's better, 1:1:1 or 2:1:1? Should we ever consider using Recombinant Factor 7a?

Plasma 130

Plasma ED OR FFP 130

EMDocs

NOVEMBER 20, 2023

For patients on VKAs to prevent stroke in nonvalvular atrial fibrillation who require reversal, 4-factor prothrombin complex concentrate (PCC) is preferred to fresh frozen plasma (FFP) because of the rapidity of INR reduction (Conditional recommendation, very low-quality evidence).

Frozen Plasma 97

Frozen Plasma FFP Plasma OR 97

Emergency Medicine Ireland

OCTOBER 28, 2020

Treatment consists of: * PLEX – actual proper PLEX with plasma replacement as opposed to just washing out all the good stuff and giving albumin as replacement. Theoretically giving them FFP while waiting on PLEX seems like it might be sensible but in reality probably does nothing when the autoantibodies are still around.

Critical Care 40

Critical Care Plasma FFP ICU 40

Core EM

JANUARY 25, 2024

Joly, 2017; Sawler, 2020) Fresh frozen plasma (FFP) (contains ADMTS-13) may be used to supplement ADAMTS-13 if there is a delay in initiating TPE in the emergency department (i.e. Decreases production of anti-ADAMTS13 antibodies by removing the B cells that mature into autoantibody-secreting plasma cells. Thrombosis Research.

Plasma 247

Plasma Frozen Plasma Emergency Department FFP 247

REBEL EM

JUNE 26, 2023

Reversal of Trauma-Induced Coagulopathy Using First-Line Coagulation Factor Concentrates or Fresh Frozen Plasma (RETIC): A Single-Centre Parallel-Group, Open-Label Randomised Trial. Severe acute traumatic coagulopathy = PT >1.5 to 3.33; P = 0.72 to 2.10; P = 0.03 PMID: 36942533 Innerhofer P et al. Lancet Haematol 2017.

FFP 140

FFP Frozen Plasma ALS Plasma 140

The Skeptics' Guide to EM

DECEMBER 17, 2022

The transfusion tech calls to remind you that your protocol is currently under review, and asks if would you like the 1:1 or the 1:3 version of fresh-frozen plasma (FFP) to packed red blood cells (pRBC)? Noting with some relief that at least he isn’t anticoagulated, you activate the hospital massive transfusion protocol.

Frozen Plasma 130

Frozen Plasma FFP Plasma Emergency Medical Services 130

ESO

MARCH 15, 2024

They received fewer PRBCs, fresh frozen plasma (FFP), and platelets across their LOS, while total units and volumes were similar. Balance resuscitation strategy, often in a 1:1:1 ratio of PRBCs with fresh frozen plasma and platelets.

Frozen Plasma 111

Frozen Plasma Plasma FFP OR 111

Don't Forget the Bubbles

JUNE 30, 2023

a) A balanced ratio of 1:1:1 (platelets: FFP: packed red cells) The PROPPR trial showed us that balanced ratios are important. 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.

E-9-1-1 140

E-9-1-1 FFP Plasma Emergency Department 140

ACEP Now

NOVEMBER 16, 2023

Fresh frozen plasma, or FFP, should only be given to cirrhotic patients as part of the massive transfusion protocol in cases of profound hypotension, as “patients with cirrhosis rarely have true enzymatic hypocoagulability, and FFP may worsen bleeding due to over-resuscitation and dilution of coagulation factors.”

Frozen Plasma 52

Frozen Plasma FFP ALS Plasma 52

ACEP Now

APRIL 5, 2024

Therapeutic plasma exchange (TPE) with fresh frozen plasma (FFP) is the first-line treatment, by simultaneously supplying fresh ADAMTS13 and removing anti-ADAMTS13 autoantibodies. Therapeutical plasma exchange for thrombotic thrombocytopenic purpura in the emergency department: A single center experience. 2021;10(3):536.

Frozen Plasma 40

Frozen Plasma Plasma FFP Emergency Department 40

EMDocs

JUNE 12, 2024

FFP and platelets also contain citrate. Two randomized controlled trials by Moore et al found that prehospital plasma administration in trauma patients is associated with hypoCa (53% vs 36%). Packed red blood cells (pRBCs) are stored with 3 grams of citrate per unit, while whole blood is stored with 1.66 grams of citrate per unit.

FFP 101

FFP ALS Plasma Emergency Department 101

The Bottom Line

MAY 23, 2025

Prothrombin Complex Concentrate vs Frozen Plasma for Coagulopathic Bleeding in Cardiac Surgery The FARES-II Multicenter Randomized Clinical Trial Karkouthi. JAMA 2025; doi:10.1001/jama.2025.3501

FFP 59

FFP Frozen Plasma Plasma OR 59