Emergency Medicine Reports saves you time keeping up with all the latest advances in a variety of clinical problems and gives you important time-saving techniques that can actually save lives in the ED!
Emergency Medicine Reports Latest Issue
Disease Presentations of the Uvula July 13, 2014
- Most infections of the uvula are viral.
- Bacterial infections are the most common cause of isolated uvulitis.
- Group A Streptococcus is the most common organism causing bacterial uvulitis.
- In cases of isolated uvular edema, think of the possibility of hereditary angioedema.
- Because thermal or chemical burns of the uvula are often associated with illegal activity, patients may not be forthcoming with this history.
Trauma Reports Latest Issue
Read the latest issue of this bimonthly, 12-page clinical monograph focusing on emergency care of adult and pediatric patients with moderate and severe traumatic injuries. Each issue gives you a practical, problem-solving, comprehensive review of a common clinical entity, packed with updated techniques you can apply immediately.
Trauma Resuscitation: The Use of Blood and Blood Products July 1, 2014
- Undifferentiated shock in trauma should be assumed to be hemorrhagic until proven otherwise. Hemorrhage represents 30-40% of mortality from trauma and may require significant volume to resuscitate.
- One pre- and post-intervention of a massive transfusion protocol showed improved outcomes with the 1:1 FFP:PRBC transfusion protocol for critically ill trauma patients at 24 hours and 30 days, and lower bleeding complications, with 18% and 21% absolute mortality reduction, respectively.
- Rapid depletion of fibrinogen has been shown in patients with significant blood loss exceeding 20% of their calculated blood volume, and fits within the conceptual understanding of the mechanism of traumatic consumptive coagulopathy.
- If thromboelastography can identify specific functional deficiencies of the traumatic coagulopathy, one can adapt the massive transfusion to simultaneously reverse the coagulopathy and shock while limiting the exposure to harm from excessive utilization of blood components.
- The most common side effects associated with PRBC transfusions reported in the CRIT trial were fever (1.9%), fluid overload (1.7%), and hypotension (1%). A pooled meta-analysis showed that the risk of developing an infectious complication was 1.8 times more likely and ARDS 2.5 times more likely with transfusion of blood.
- Clinical findings of TRALI are tachypnea, cyanosis, frothy pulmonary secretions, dyspnea, hypotension, tachycardia, and fever within 6 hours of transfusion, although most cases occur within 1-2 hours.