Tag: bleeding
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?
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
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
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
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
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
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?
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
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?
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
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
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