EMDocs

DECEMBER 6, 2024

Antidote : Deferoxamine is a chelating agent derived from Streptomyces pilosus ; binds free iron from plasma and iron inside of cells. Coagulopathy: Parenteral vitamin K and/or fresh frozen plasma (FFP) as clinically indicated. 9 Typical dose: Polyethylene glycol (Go-Lytely ) 25 mL/kg/hr in small children and 1.5-2 2 L/hr in adults.

E-9-1-1 96

E-9-1-1 Frozen Plasma Plasma Overdose 96

Don't Forget the Bubbles

APRIL 7, 2025

As dehydration can rapidly worsen in children , this test must be performed in a hospital setting with strict monitoring.

E-9-1-1 70

E-9-1-1 Plasma ALS OR 70

EMDocs

MAY 17, 2025

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. 17 TEG and ROTEM are non-invasive tests that quantitatively measure the ability of whole blood to form a clot.

E-9-1-1 103

E-9-1-1 EMS FFP Frozen Plasma 103

ACEP Now

MAY 9, 2025

DDAVP causes release of endogenous coagulation factors such as factor VIII, von Willebrand factor (vWF), and tissue plasminogen activator (tPA) which increases plasma factor levels, enhances platelet adhesion, and reduces bleeding time.

Allergic Reaction 52

Allergic Reaction ALS Plasma Epinephrine 52

EMDocs

MAY 27, 2025

11 Transfuse patients who are anemic or coagulopathic, ideally with fresh whole blood; if this is not available, use packed red blood cells (PRBCs) for anemia, and replete coagulopathy with platelets, fresh frozen plasma (FFP), or cryoprecipitate as indicated. Severe Malaria 11 Defined as the presence of P.

ED 82

ED Plasma Frozen Plasma ALS 82

EMDocs

FEBRUARY 22, 2025

Although the concentration of chloride in the CSF is slightly higher than in plasma, measuring chloride (B) is not an accurate way to detect the presence of CSF. Timely management is essential to reduce the risk of complications, such as meningitis and chronic headaches, which may significantly impact a patients quality of life.

E-9-1-1 62

E-9-1-1 EMS Plasma OR 62

Core EM

JANUARY 25, 2024

Comparison between Prothrombin Complex Concentrate (PCC) and Fresh Frozen Plasma (FFP) for the Urgent Reversal of Warfarin in Patients with Mechanical Heart Valves in a Tertiary Care Cardiac Center. Iran J Pharm Res. 2015;14(3):877-885. Fariborz Farsad B, Golpira R, Najafi H, et al.

Frozen Plasma 246

Frozen Plasma FFP Plasma Critical Care 246

Pediatric EM Morsels

MARCH 29, 2024

Your genetics and inpatient colleagues will thank you!

ED 300

ED Plasma OR EMS 300

The Skeptics' Guide to EM

JUNE 12, 2022

sodium chloride), and balanced crystalloid solutions, meaning those with a chloride composition closer to plasma such as lactated ringer’s or Plasma Lyte 148. Then, the BaSICS trial (a multicentred RCT done in 75 Brazilian ICUs) came along and compared saline to Plasma-Lyte at what the authors deemed slow and fast infusion rates.

ICU 132

ICU Plasma Critical Care ALS 132

EMergucate

JULY 18, 2012

– fasting plasma glucose > 7 mmol/L – symptoms + random plasma … Continue reading → When do you diagnose your patient with diabetes?

Plasma 100

Plasma 100

The Skeptics' Guide to EM

JUNE 18, 2022

The paramedic asks you, “we have saline, and we also have red-cells and this fancy new lyophilised plasma. Should we give our shocked patient saline or plasma / red cells en route to the ED?” It was a pragmatic, randomised, single-centre trial done at the Denver looking at the use of plasma in the prehospital setting.

Plasma 100

Plasma Critical Care ALS Paramedic 100

Pediatric EM Morsels

JULY 26, 2024

First line therapies for anti-NMBDA receptor encephalitis consists of… High dose steroids , IVIG, and PLEX – Therapeutic plasma exchange Only 50% of patient’s respond, and will require second line therapies such as Rituximab. IV acyclovir for HSV coverage while awaiting PCR results.

Plasma 274

Plasma OR ED Critical Care 274

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

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 101

Frozen Plasma Allergic Reaction FFP Plasma 101

Core EM

JULY 23, 2024

Hyperkalemia Cardiac conduction partially depends on a gradient of lower extracellular (plasma) potassium levels and higher intracellular potassium levels. The patient was admitted to the medical intensive care unit and emergent underwent dialysis. His EKG on discharge is shown below.

Plasma 130

Plasma Emergency Department Overdose OR 130

Medgadget

OCTOBER 20, 2022

This involves using a plasma ray that glows a pleasing pink color and methane gas as a carbon source. The plasma causes the methane to dissociate into reactive species and then the carbon can be deposited onto the surface of the electrical components. See a video about the technique below. Via: CalTech.

Plasma 92

Plasma ACS 92

Core EM

JANUARY 24, 2024

Hyperkalemia Cardiac conduction partially depends on a gradient of lower extracellular (plasma) potassium levels and higher intracellular potassium levels. The patient was admitted to the medical intensive care unit and emergent underwent dialysis. His EKG on discharge is shown below.

Plasma 130

Plasma Emergency Department Overdose OR 130

ALiEM

OCTOBER 20, 2023

Necrobiosis Lipoidica – This patient had a previous skin biopsy with histopathologic changes demonstrating a granulomatous dermatitis involving the dermis and subcutaneous tissues with necrobiosis of collagen and inflammatory infiltrates of lymphocytes and plasma cells consistent with a diagnosis of necrobiosis lipoidica. to 1.2%).

Plasma 161

Plasma Coronary Emergency Department OR 161

Core EM

JANUARY 24, 2024

Background Around 6 million people in the U.S. 2017 ACC Expert Consensus Decision Pathway on Management of Bleeding in Patients on Oral Anticoagulants: A Report of the American College of Cardiology Task Force on Expert Consensus Decision Pathways.

FFP 130

FFP Frozen Plasma Plasma ALS 130

Chicago EMT Training

AUGUST 6, 2021

Various assistant/tech roles around the hospital/Plasma Donation Centers I personally became an Anesthesia Technician at Northwestern solely off of my experience as a paramedic and have been fortunate to bring on coworkers who were EMT students of ours.

EMT 130

EMT EMT Plasma Paramedic 130

The Skeptics' Guide to EM

APRIL 6, 2019

In contrast, protamine could be used for heparin and LMWH reversal and vitamin K, fresh frozen plasma and prothrombinase complex concentrate could be used to reverse coumadin ( Hunt and Levi BMJ 2018 ). Level A One of the concerns clinicians had with DOACs was there was no way to reverse these new anti-coagulants when they were introduced.

Frozen Plasma 130

Frozen Plasma Plasma ALS EMS 130

Pediatric EM Morsels

JUNE 14, 2024

Diagnostic Criterion for ATM (Tavasoli 2018, Wang 2019) Bilateral sensory, motor, and autonomic dysfunction localized to one OR more spinal segment No evidence of compressive cord lesion Enhancing lesion on MRI Pleocytosis or elevated immunoglobulin type G (IgG) index Transverse myelitis consortium working group can be applied to children May (..)

Plasma 144

Plasma ALS OR EMS 144

Dr. Smith's ECG Blog

MAY 22, 2024

Don't forget beta agonists in the treatment of hyperkalemia: Terbutaline and Albuterol for Lowering of Plasma Postassium (includes many abstracts) The below abstracts show that beta 2 adrenergic agonists are effective at treating hyperkalemia. Is This a Simple Right Bundle Branch Block? They do so by "shifting" K into the cells. --0.5

Plasma 120

Plasma ICU OR 120

Core EM

OCTOBER 16, 2024

Author: Natalie Bertrand, MD Editor: Naillid Felipe, MD Background: Definition: adverse reaction to blood product administration Incidence: more common in children than adults, except for delayed hemolytic transfusion reactions Allergic (non-anaphylaxis) – Platelets 1-3%; RBCs 0.1-0.3% mg IF requiring IM Epi >3x, switch to IV Epi, 0.05-0.1

Allergic Reaction 188

Allergic Reaction Plasma ED Epinephrine 188

EMDocs

MAY 23, 2024

3 Measured in analytical testing : Laboratories measure plasma concentration using osmometers which measures values as a function of kilograms of solvent. Choice of the best equation for plasma osmolality calculation: Comparison of fourteen formulae. Validation of equations used to predict plasma osmolality in a healthy adult cohort.

Plasma 86

Plasma EMS ED OR 86

EMDocs

AUGUST 31, 2023

Plasma half-life of the F(ab’) 2 antivenom is significantly longer at 5.5 F(ab) is smaller, consisting of a single antigen binding site, while F(ab’) 2 consists of two antigen-binding sites linked together by an antibody “hinge” region. This size difference may lead to differences in the pharmacokinetic profiles of the two antibodies.

Allergic Reaction 94

Allergic Reaction Plasma ALS ACS 94

Emergency Medicine Ireland

APRIL 16, 2024

This time the tonicity is high from something else such as high glucose or mannitol drawing water from cells into plasma. A normal sane and functioning kidney will try and lose water to conentrate the plasma in order to bring the sodium back up to normal, in other words the kidney should be producing a dilute urine with a low osm.

Critical Care 74

Critical Care Plasma OR ED 74

EMDocs

APRIL 10, 2024

Metabolism of ester anesthetics is by plasma cholinesterase, whereas amides are metabolized by the cytochrome P450 system in the liver. [6] 6] Action of local anesthetics is dependent upon the molecule crossing the plasma membrane in a unionized form. [2] 2] This linking group can be either an amide (e.g., lidocaine) or an ester (e.g.,

E-9-1-1 103

E-9-1-1 Plasma Epinephrine ED 103

Critical Care Scenarios

JANUARY 10, 2021

You may consider remdesevir or convalescent plasma at this point in the science, but don’t expect too much effect.* Very prolonged courses on non-invasive positive pressure ventilation (CPAP/BiPAP) may be more acceptable here than in other diseases; although not very appealing it may be preferable to intubation.

Critical Care 100

Critical Care Plasma ICU OR 100

Critical Care Scenarios

OCTOBER 31, 2021

Plasma free hemoglobin levels may be a useful marker that changing your oxygenator could improve gas exchange.* .* Hypoxemia can occur in VV ECMO patients due to too much flow through the native circulation and shunted lungs. In such cases, beta blockade may actually improve systemic oxygenation.*

Interfacility Transport 100

Interfacility Transport Plasma ICU EMS 100

Emergency Medicine Ireland

MARCH 13, 2023

In broad terms we can compare dialysis (the movement of small molecules across a membrane along an osmotic gradient) with ultrafiltration (the squeezing of plasma through a big sieve that retains the big bits of the plasma and lets the other bits leak out).

Critical Care 52

Critical Care Plasma ICU OR 52

Medgadget

MAY 11, 2023

Red cells are healthy monocytes, green and yellow are plasma cells. Study in Nature Cancer : Ex vivo drug response heterogeneity reveals personalized therapeutic strategies for patients with multiple myeloma Image credit: Bone-​marrow cells of a multiple myeloma patient. Image: Berend Snijder Lab / ETH Zurich) Via: ETH Zurich

Plasma 79

Plasma OR 79

Emergency Medicine Ireland

JUNE 7, 2021

In the plasma itself, 50% is ionised, 40% is plasma bound and 10% is chelated to various anions. There is a large gradient between the ionised calcium in the plasma and the tiny ionised fraction in the cells. So as an important starter, the serum level of calcium does not tell us much about overall levels in the body.

Critical Care 52

Critical Care Plasma ICU OR 52

Emergency Medicine Ireland

MARCH 7, 2022

On the other hand, lymphoid cells have a much smaller and narrower family tree differentiating into different types of lymphocytes and plasma cells. This is a cancer of plasma cells which are the grown up and left home versions of B lymphocytes. Finally on the list of common haematological malignancies is multiple myeloma.

Critical Care 52

Critical Care Plasma ICU OR 52

Emergency Medicine Ireland

FEBRUARY 11, 2021

Up front there are some problems with the terminology * Plasmapheresis = process of removing plasma from the blood.

Critical Care 40

Critical Care Plasma ICU OR 40

The Overrun Podcast

MAY 23, 2019

Mark Merlin on Twitter at : @ccareanywhere The NJ EMS and Disaster Medicine Fellowship can be found at: www.emsfellowship.com The MD1 physician response program: www.md1program.org Dr. Qasim is on Twitter at: @emeddoc Dr. Callelo: @DrDianeC, @njpoisoncenter, also at @ToxAndHound The COMBAT trial for prehospital plasma: [link] The PAMPHER trial: [link] (..)

EMS 52

EMS Plasma Epinephrine CPR 52

The Overrun

JUNE 3, 2023

Through the years, we see a change to plasma, then crystalloid, and then 1:1:1 therapy. Once compared, while 1:1:1 therapy or giving PRBCs or plasma alone is better than crystalloid, whole blood is preferable and may have more of a survival benefit for patients. In the First World War, the preferred resuscitation fluid was whole blood.

Plasma 52

Plasma Paramedicine Paramedicine EMS 52