Resuscitation of Endotheliopathy and Bleeding in Thoracic Aortic Dissections

Resuscitation of Endotheliopathy and Bleeding in Thoracic Aortic Dissections

In this randomized, clinical pilot trial of patients undergoing emergency surgery for thoracic aorta dissections, we found that OctaplasLG reduced glycocalyx and endothelial injury, reduced bleeding, transfusions, use of... read more

Why Do Bleeding Trauma Patients Die?

Why Do Bleeding Trauma Patients Die?

It is important that we recognize that we have seen a reduction in the number of deaths from trauma. That's a great thing of course, but we should not be complacent. It's also worth looking at where and how patients die.... read more

What’s the Bleeding Problem with Trauma Laparotomies?!

Mortality for hypotensive trauma patients undergoing emergency laparotomy have not changed in 20 years. This blog explores the literature and the future! Wait! We're emergency physicians, why do we care about laparotomies?!... read more

Transient Systolic Anterior Motion with Junctional Rhythm After Mitral Valve Repair in the ICU

Transient Systolic Anterior Motion with Junctional Rhythm After Mitral Valve Repair in the ICU

This case report shows that junctional rhythm can cause deterioration of SAM, LVOTO, and MR, and can lead to unstable hemodynamics in a patient with right ventricular failure after MVR. Atrial pacing can resolve SAM, LVOTO,... read more

EHR-guided Strategy Reduces Postop VTE Events

EHR-guided Strategy Reduces Postop VTE Events

By incorporating algorithms into the electronic health record (EHR), UPMC was able to realize a "dramatic" 72% reduction in missed doses, from 4,331 missed doses in 2014 to 1,193 in 2015, Dr. Neal told attendees in a session... read more

Airway Management Techniques during Massive Regurgitation, Emesis, or Bleeding

Airway Management Techniques during Massive Regurgitation, Emesis, or Bleeding

Friend to the show, Jim DuCanto has been obsessed with SALAD. Not the leafy greens delicately touched with a tart emulsion, but with Suction Assisted Laryngoscopy and Airway Decontamination (SALAD). Jim DuCanto, MD is an... read more

Management of the Traumatized Airway

Management of the Traumatized Airway

There is a lack of evidence-based approach regarding the best practice for airway management in patients with a traumatized airway. Airway trauma may not be readily apparent, and its evaluation requires a high level of suspicion... read more

Early Hemorrhage Control and Management of Trauma-induced Coagulopathy

Early Hemorrhage Control and Management of Trauma-induced Coagulopathy

Trauma resuscitation should focus on early goal-directed therapy with use of viscoelastic hemostatic assays while initially applying a ratio 1:1:1 driven transfusion therapy (with red blood cells, plasma and platelets) in... read more

Bleeding During Percutaneous Dilatational Tracheostomy – What to do while waiting for the surgeon?

Bleeding During Percutaneous Dilatational Tracheostomy – What to do while waiting for the surgeon?

A patient suffered significant bleeding during an attempt at percutaneous dilatational tracheostomy due to an aberrant anterior jugular vein. Bleeding was controlled with pressure temporarily, but quickly returned necessitating... read more

Pharmacomechanical Catheter-Directed Thrombolysis for Deep-Vein Thrombosis

Pharmacomechanical Catheter-Directed Thrombolysis for Deep-Vein Thrombosis

The post-thrombotic syndrome frequently develops in patients with proximal deep-vein thrombosis despite treatment with anticoagulant therapy. Pharmacomechanical catheter-directed thrombolysis (hereafter "pharmacomechanical... read more

Should All Massively Transfused Patients Be Treated Equally?

Should All Massively Transfused Patients Be Treated Equally?

Although balanced resuscitation has become integrated into massive transfusion practice, there is a paucity of evidence supporting the delivery of high ratios of plasma and platelet to RBCs in the nontrauma setting. This... read more

Venous Thromboembolism Prophylaxis in Major Orthopedic Surgery

Venous Thromboembolism Prophylaxis in Major Orthopedic Surgery

Few head-to-head treatment comparisons have sufficient evidence. Most studies evaluated low molecular weight heparin (LMWH), not low-risk interventions (such as aspirin and mechanical devices); most reported on total deep... read more

Thrombocytosis in the ED

Thrombocytosis in the ED

Both reactive thrombocytosis and clonal thrombocytosis may be associated with vasomotor symptoms. The key difference is that thrombotic and bleeding events are much more common in myeloproliferative thrombocytosis, whereas... read more