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TXA for angioedema emcrit

IBCC chapter & cast - Angioedema - EMCrit Projec

Treatment of ACEi-induced angioedema - EMCrit Blo

  1. IBCC - Elevated intracranial pressure (ICP) ICP elevation is an important dimension of many neuroICU patients. Unfortunately, it remains unclear precisely who might benefit from ICP monitoring, or exactly what the optimal ICP targets should be. The IBCC chapter is located here. The podcast & comments are below. Follow us on iTunes. 1. 2. 3
  2. A transient, localized, non-pitting distention of the skin (subcutaneous layer) or the respiratory and gastrointestinal tracts (submucosal layer) Inflammatory mediators cause vascular permeability, allowing fluid to diffuse into the interstitium. Effects areas with loose connective tissue, like the oropharynx, extremities, and genitalia
  3. Tranexamic acid is a medication that helps enhance blood clotting and is typically used to treat bleeding problems. However, it has also been shown to help prevent attacks in hereditary angioedema (HAE)

Angiotensin-converting enzyme (ACE) inhibitors are the leading cause of drug-induced angioedema in the United States because they are so widely prescribed. Patients most commonly present with swelling of the lips, tongue, or face, although another presentation is episodic abdominal pain due to intestinal angioedema Angioedema in the emergency department: a practical guide to differential diagnosis and management. Jonathan A Bernstein. Int J Emerg Med. 2017. Tranexamic acid as first-line emergency treatment for episodes of bradykinin-mediated angioedema induced by ACE inhibitors. Beauchêne C. Rev Med Interne. 2018 . Angioedema; EMCrit Let's focus on the more confusing treatments for bradykinin-mediated angioedema. Tranexamic Acid (TXA) Theory: TXA inhibits the conversion of plasminogen to plasmin (which is why we use it for bleeding). But that step is also key to bradykinin generation Angioedema is a clinical diagnosis characterized by the abrupt onset of non-pitting, non-pruritic swelling that involves the reticular dermis, subcutaneous, and submucosal layers. Angioedema may be life-threatening, depending on the underlying cause and the body location affected. Airway involvement is usually the immediate life-threat Angioedema. Angioedema is estimated to occur in 1.3 - 5.1% of stroke patients receiving tPA, although the risk is much higher for those patients on concomitant ACE inhibitor medications (Relative Risk [RR] 13.6) and, interestingly, in those patients with early signs of ischemia of the insular and frontal cortex on initial CT brain (RR 9.1) 4,5..

PulmCrit Wee: Reconceptualizing bradykinin - EMCrit Blo

  1. ↑ C Beauchene et al. Tranexamic Acid as First-Line Emergency Treatment for Episodes of Bradykinin-Mediated Angioedema Induced by ACE Inhibitors. Rev Med Interne. 2018 Oct;39 (10):772-776
  2. TXA is not a new drug. Studies from the late 1960s and early 1970s have shown reduced bleeding and need for transfusions in many surgical and medical settings. Fast forward to today and we are finding all kinds of uses for TXA other than trauma including post-partum hemorrhage, epistaxis, hemoptysis, gastrointestinal hemorrhage, and many more
  3. ogen to plas
  4. As Emergency Physicians, we are always looking for ways to improve the care we provide to our patients. Based on clinical data which have come to light over the past several years, tranexamic acid (TXA) displays considerable promise toward reducing mortality in hemorrhagic trauma. It's widely available, cost-effective, and an easy way to save lives. Let's take a look at the evidence and.
  5. e or bradykinin mediated, and they list out a few distinguishing features. TXA is a treatment for bradykinin mediated angioedema. level
  6. Scott Weingart. Podcast 129 - LAMW: The Neurocritical Care Intubation. EMCrit Blog. Published on July 26, 2014. Scott Weingart. Podcast 78 - Increased Intra-Cranial Pressure (ICP) and Herniation, aka Brain Code. EMCrit Blog. Published on July 22, 2012. Specogna AV, Turin TC, Patten SB, Hill MD
  7. Taper 5 mg/d every week at prednisone doses 40-20 mg/d. Taper 2.5 mg/d every two weeks at prednisone 20-10mg/d. Taper 1 mg/d every 2 weeks at prednisone 10-5 mg/d. Generally we will only give 1-2 week course of medications from the ED, so make sure to do the calculations and give endocrine follow-up. Takeaways

[Tranexamic acid as first-line emergency treatment for

  1. Massive Transfusion Protocol (MTP) is an important step in most trauma protocols. By recognizing the severity of injury and intervening quickly by giving blood products upfront, MTP has been shown to decrease ICU length of stay, decrease ventilator length of use, decrease mortality rates, and has been shown to decrease the number of blood products needed over the entire length of stay
  2. Uvulitis is characterized by inflammation and edema of uvula. Isolated uvular inflammation is rare. More commonly manifests with other inflammatory diseases of oropharynx: Epiglottitis. Pharyngitis
  3. A CPP goal of 50 to 70 mm Hg should be used, with SBP of at least 100 mm Hg (ages 50-69) and 110 mm Hg for 15-49 years and > 70 years, per the Brain Trauma Foundation. 2,8,11-13 Otherwise, a MAP of 70-80 mm Hg is advised. 5 Avoiding cerebral hypotension is recommended, though aggressive CPP targeting is not associated with improved outcomes. 13.

But TXA and FFP do. Great breakdown of the topic by EMCrit. CONTENTS Overview Diagnosis of angioedema Histamine-mediated vs bradykinin-mediated angioedema Airway management Histamine-mediated angioedema Bradykinin-mediated angioedema Pathophysiology Differential diagnosis Evaluation Treatment Extubating the angioedema patient Algorithms Podcast. Edema of the uvula, tonsillar pillars, and tongue is common. Within 24hrs a Fibrin clot on the tonsillar fossae develops. By the 5th day post-op, the Fibrin clot has proliferated and made a thick cake (that looks terrible) Author: Dr. Harrison Pidgeon Background: TXA, or tranexamic acid, has been used for everything from traumatic hemorrhage and post-partum bleeding to post tonsillectomy bleeding and angioedema. But what about for Read Mor

French K, White J, Hoesch R. Treatment of intracerebral hemorrhage with tranexamic acid after thrombolysis with tissue plasminogen activator. Neurocrit Care. 17:107-111, 2012. Chauhan S, Gharde P, Bisoi A, et al. A comparison of aminocaproic acid and tranexamic acid in adult cardiac surgery. Ann Card Anesth. 7(1): 40-3, 2004 Angioedema may co-exist with urticaria, which is typically an itchy,raised, red rash with indistinct margins. 3 Drug-induced angioedema can develop over a few minutes to hours, is usually self-limiting and resolves quickly. Sometimes recov-ery can take longer, but angio-edema is unlikely to persist for more than three to four days. 4 Angioedema. Asterixis is defined as flapping motion of outstretched, dorsiflexed hands. 36-39 Focal neurologic deficits (most commonly hemiplegia) can also be present in up to 17%, despite normal imaging. 41 Overt encephalopathy, if present with severe cerebral edema, can lead to coma. 36,37,4

Angioedema — Maimonides Emergency Medicine Residenc

Efficacy of tranexamic acid in sporadic idiopathic

  1. This is Part 2 of EM Cases main episode podcast on Burn, Inhalational and Electrical Injuries. In Part 1 Dr. Joel Fish and Dr. Maria Ivankovic and Anton discussed wound care, resuscitation and airway management of the burn and inhalation injury patient, with a segment on awake intubation by George Kovacs. Electrical injuries are rare, representing less than 1% of burn center admissions
  2. Angioedema is a deep dermal, submucosal or subcutaneous swelling associated with vascular leakage. Patients with a known diagnosis tend to understand their peripheral swellings and so will only present to the Emergency Department when they are suffering an attack that is different, more painful or is life threatening
  3. More recently, IV tranexamic acid has been used as a front-line emergency therapy to reverse episodes of ACE-induced angioedema. The efficacy of this intervention is controversial, but this is a safe and inexpensive therapy and may help while waiting for a more specific treatment. More on this at: https://pubmed.ncbi.nlm.nih.gov/29735174
  4. Here is the link to Dr. Weingart's site EMCrit.. These are notes that I made of Dr. Weingart's outstanding podcast, EMCrit Podcast 19 - Non-Invasive Ventilation February 5, 2010 , so I could quickly review it when I wanted to[this link is to the podcast and show notes]. I've done my best to make sure it accurately reflects what Dr. Weingart said

Angioedema is the swelling of deep dermis, subcutaneous, or submucosal tissue due to vascular leakage. [1, 2] Acute episodes often involve the lip, eyes, and face (see the image below); however, angioedema may affect other parts of body, including respiratory and gastrointestinal (GI) mucosa.Laryngeal swelling can be life-threatening TXA - antifibrinolytic and therefore inhibits plasmin production -> decreases bradykinin production. Patient's on ACE-i with angioedema. Did not standardize dose/timing of TXA administration. Clinical improvement was subjective, did not define criteria. Intubation as deemed necessar In this post I link to NeuroEMCrit - Everything you wanted to know about Hyperosmolar agents for the Management of ICP and Cerebral Edema [Link is to the show notes as there is no podcast], October 11, 2020 by Dr Neha Dangayach from EMCrit.. Editors Note: This is the first NeuroEMCrit post. NeuroEMCrit is a section from our newest EMCrit team member, Neha S. Dangayach MD EMCrit Podcast 5 - Intubating the Critical GI Bleeder and A novel set-up to allow suctioning during direct endotracheal and fiberoptic intubation on EMCrit. Upper GI Bleeding, Answers on EM Lyceum. The unstable patient with a gastrointestinal bleed, Approach to the sick cirrhotic patient, and Intubating the gastrointestinal bleeder on.

In this post I link to and excerpt from EMCrit 275 - NeuroCritical Care with Neha Dangayach. June 10, 2020 by Scott Weingart, MD FCCM. Note to myself: The show notes, which I've excerpted below are outstanding. However, the podcast itself should be reviewed over and over. The lecture has much more than just the great show notes Indications for use of Tranexamic Acid (TXA) Trauma . Trial Name: CRASH 2 (Positive trial). Trial Type: Multicenter, double-blind RCT Sample size: 20,211 Dose/Route of TXA: Loading dose 1g over 10 min, then infusion of 1g over 8hr Primary outcome: All-cause mortality within 4 weeks of injury. Secondary outcome: Vascular occlusive events (AMI, stroke, PE, and DVT), surgical intervention. Vasoplegia is the syndrome of pathological low systemic vascular resistance, the dominant clinical feature of which is reduced blood pressure in the presence of a normal or raised cardiac output. The vasoplegic syndrome is encountered in many clinical scenarios, including septic shock, post-cardiac bypass and after surgery, burns and trauma, but despite this, uniform clinical definitions are.

EMCrit Blog - Emergency Department Critical Care

  1. 1Lit (VPN Required) EMA: Acute severe/near fatal asthma. AnnEmergMed: Pulm HTN and RV Failure in EM. BJA: Management of life-threatening asthma in adult
  2. REBEL EM has primarily been a clinical blog focusing on critical appraisal of research, but now we are proud to introduce REBEL Core, an initiative to improve discussion of core content in emergency medicine/critical care.Free Open Access Medical Education (FOAMed) has long been dedicated to discussing current literature to shorten knowledge translation
  3. 3 way stop cock. Suture. Take the catheter (that is used for vessel cannulation -NOT the trilumen catheter out of central line kit). It is typically preloaded on the needle. Take the catheter off the central line kit needle and place it on the spinal needle. It is an 18 Gauge Catheter so the spinal needle should fit

Angioedema - Core E

And here are links to two awesome resources on Angioedema from Core EM:. Here is the link to the podcast and show notes of Episode 107.0 Angioedema by Anand Swaminathan, MD, MPH [Link is to a list of Dr. Swaminatham's excellent articles on the site]:. Take Home Points. Airway management is paramount, expect a challenging intubation and consider controlling the airway earl This is an update on delayed sequence intubation from EMCrit Podcast 137 - Delayed Sequence Intubation (DSI) Update posted on November 17, 2014 by Dr. Scott Weingart.. The first podcast on Delayed Sequence Intubation is EMCrit Podcast 40 - Delayed Sequence Intubation (DSI) [He says that #137 is the one to review.] which Dr. Weingart published Jan 3, 2011

TXA (tranexamic acid) in trauma - a nice review from emDocs. Of note, the reasons why you haven't seen this given at Grady is because it's stocked in the OR and the Continue reading. Leave comment; FOAM of the Week 10/27/15 - Anticoagulation Reversal, Dental Traum Review Article CRASH-2 Study of Tranexamic Acid to Treat Bleeding in Trauma Patients: a Controversy Fueled by Science and Social Media. Hugh McAss. Download PDF. Download Full PDF Package. This paper. A short summary of this paper. 37 Full PDFs related to this paper. READ PAPER

(1) CRASH-2 was a randomized, placebo-controlled trial that spanned 274 hospitals in 40 countries that sought to assess the effects of the early administration of a short course of tranexamic acid on death, vascular occlusive events, and the receipt of blood transfusion in trauma patients [1].(2) Adult trauma (>16 years) patients with significant hemorrhage (systolic blood pressure <90. EMCrit: IBCC: Angioedema: Josh Farkas, MD: 1 Aug 2019: AIR: EMDocs: Prolonged Pediatric Fever and Evaluating Patients for Kawasaki Disease, Toxic Shock Syndrome, and Multi-inflammatory Syndrome of Children: Chance Sullivan, MD, Skyler Lentz, MD, and Joe Ravera, MD: 3 Aug 2020: AIR: EMCrit/PulmCrit: How to Use IV Epinephrine for Anaphylaxis. EMCrit Podcast - Critical Care and Resuscitation. Help me fill in the blanks of the practice of ED Critical Care. In this podcast, we discuss all things related to the crashing, critically ill patient in the Emergency Department. Find the show notes at emcrit.org Angioedema is a subcutaneous extension of urticaria, resulting in deep swelling within subcutaneous sites. [emedicine.com] In hereditary angioedema, caused by a defect in the immune system, swellings in the intestinal tract may produce pain, vomiting, or diarrhea, and edema of the larynx may cause death by asphyxiation. [britannica.com

Tranexamic Acid - Angioedema New

Am J Emerg Med. 2015;33 (1):72-5. PMID: 25455047. This is an observational study, looking at a period before and after CK-MB was removed from an automatic order set. Out of 6444 cases included in the study, there were only 17 cases with a positive CK-MB fraction and a negative troponin. All 17 were ultimately determined by the treating. A 40-year-old male reported to the emergency department with complaints of pain and swelling under the left eye and an ulcer on the roof of his mouth for the past 2 weeks. Pain was gradual in onset with swelling over the left maxillary sinus now causing nasal obstruction and edema Read More

Swelling out of the Blue - Angioedema in the ED. Angioedema is like urticaria in that both are transient swelling of well-demarcated areas. However, angioedema involves swelling of deeper tissues, producing nonpitting edema of the dermis and subcutaneous layers. It is most often seen in the eyelids and lips, and sometimes in the mouth and throat The use of tranexamic acid (TXA) in epistaxis and mucosal bleeding has been a topic of interest. While research is equivocal, studies are promising regarding TXA application for nasal packing. 11-13 The TXA dosing in Zahed et al.'s paper was 500 mg in 5 mL, applied on the nasal tampon. 11. I nterventional Radiology or S urger

UpToDat

TXA is short for tranexamic acid. Most often use in the ED is with severe bleeding or problematic bleeding associated with trauma. Crash II trial determined the benefit of TXA is only applicable for about three hours after a trauma. Typical dosing is 1 gram in the first ten minutes and 1 gram over the next eight hours For more on this subject, check out this great post on EMCrit on Fluids in sepsis: a new paradigm Recorded at the Maine Medical Center Winter Symposium in 2017. David Mackenzie, MDCM, FRCPC, FACEP. Assistant Professor of Emergency Medicine Maine Medical Center Tufts University School of Medicine References. 1. Marik PE, Bellomo R

Angioedema - The Resus Roo

CXR: To evaluate for signs of heart failure, cardiomegaly, pulmonary edema, PNA, driveline damage; POCUS: LV and RV function, signs of RH strain may signify pulmonary hypertension or a PE. Overdistended LV may indicate pump malfunction, thrombus or severe aortic regurgitation. Check for pericardial effusion or tamponade as well Core Emergency Medicine. Acid-Base Workshop: At the beginning of the conference year, multiple faculty members ran a workshop on acid-base abnormalities where we worked on identifying acid-base disturbances, determining primary respiratory or metabolic abnormalities, causes of such disturbances, and if compensation was appropriate by Donna Venezia Introduction History of the ABC's The basic ABC algorithm was initially designed and implemented on a large scale in the early 1960's for those requiring cardiac-pulmonary resuscitation. The order has recently been changed to the CAB for those who have suffered a cardiac arrest (See BLS/ACLS - Cardiac Arrest section). Twenty years Continue reading The ABC Approach to.

Updates in Angioedema Management — Tim So

Hypotensive patients requiring volume resuscitation are a regular occurrence for emergency physicians. Clinicians are often faced with determining whether patients will respond favorably to IV fluids both before and during vasopressor administration. The ability for point of care ultrasound (inclu Actually quite rare! In 30,000 patients, TdP occurred once (the patient had multiple risk factors and TdP didn't reoccur when re-challenged). Prior data covered in 2015 @aaeminfo position statement Background. Alpha-2 agonists that reduce sympathetic output may be effective adjunct treatment modalities without suppressing respiratory drive. Some older studies using clonidine demonstrated possible benefit. Similarly, there are several case reports and four case series using dexmedetomidine (a parenteral alpha-2 agonist) in addition to benzodiazepines Tranexamic acid (1g IV) +/- oxytocin (40U by IV in 1L NS at 150cc/hour) can be given to slow bleeding before definitive management (in the OR). ** In an unstable patient with massive vaginal bleeding, a pelvic exam is indicated to identify a source and to look for and extract tissue found in the cervix

The majority of cases are mild and self-limiting. Few will progress to life threatening levels of edema and airway compromise Fresh frozen plasma (FFP), C1-inhibitor concentrate, icatibant, ecallintide, and even TXA are potential medical therapies, but no direct evidence for their use in tPA induced angioedema so far Brrrr, it's cold out there. Internet Book of Critical Care Hypothermia. EMCrit: Severe Accidental hypothermia Annals of EM: Classic annals paper on thoracic lavage Put 'em to sleep, but not too deep. CHEST: Emergency department sedation in mechanically ventilated patients Crit Care Med: Early Sedation meta-analysis Crit Care Med: ED-SED prospective study. Angioedema: 2 types . Bradykinin. Histaminergic. Treatment: H1 blockers. Steroids. Epinephrine. TXA: Literature shows no help in the acute side, maybe in hereditary in prevention. 2 yo M with a Fever x4 days. Physical exam: AOM . Given antibiotics and discharged. Comes back in after 4 days on abx with swelling now. Physical exam: Swelling and.

Angioedema • LITFL Medical Blog • CCC Airwa

Angioedema is the swelling of deep dermis, subcutaneous, or submucosal tissue due to vascular leakage. When this swelling involves the upper airway, angioedema can be life-threatening. ACE inhibitor induced angioedema is related to elevated levels of bradykinin. Swelling usually develops over minutes to hours, peaks, and then resolves over 24. Epidemiology. Trauma is the leading cause of death in individuals aged 1-45, with traumatic brain injury (TBI) responsible for the majority of these, over 50,000 deaths per year in the United States. 1-3 TBI can be clinically stratified into mild, moderate, and severe based on the Glasgow Coma Scale Score (GCS), with associated permanent disability rates of 10, 60, and 100%, respectively. increased risk of blood clotting. fluid accumulation in the brain. a clot in the small veins that carry blood to or from the retina of the eye. a heart attack. acute blood clot in a blood vessel. Hereditary angioedema is a rare disorder identified by episodes of swelling under the skin, gut lining, and the lungs. Learn its triggers, treatments and more

Ultrasound for Detection of Pneumothorax. Typically, the initial evaluation of blunt trauma patients involves a supine anteroposterior (AP) chest x-ray (CXR) which has a poor sensitivity for the detection of pneumothorax (PTX), and has been reported as low as 20% - 48%. Following the CXR computed tomography (CT) has been the standard for the. Oral Boards Practice Cases Case 1 - 22 yo F in a coma with normal vital signs. Not responding to Narcan and Dextrose. Found in a garage. On exam, she has sluggish and dilated pupils. pH 6.98, pCO2 29, bicarb 2 High concern for toxic alcohol ingestion: consul Can also try surgicel/gelfoam. Afrin (oxymetazoline) a few squirts up the nose. Soak cotton swabs in lidocaine with epi, put as many as possible into nares (4-5) leave for 10 minutes. 4% Cocaine (still the best, comes in a slurry) 4% Lidocaine mixed 1:1 with 1% phenylephrine. Oxymetazoline 0.05% (Afrin nasal spray) and 4% lidocaine 1:1

Hereditary angioedema (HAE) is a disease characterized by recurrent episodes (also called attacks) of severe swelling of the skin and mucous membranes. The age at which attacks begin varies, but most people have their first one in childhood or adolescence. The frequency of attacks usually increases after puberty Hi folks! This episode , as part of Surgical airway month of July 2012, I interview Dr Jordan Schooler an EM Resident in USA. He has just recently completed internship and was doing his first ICU resident shift when a patient with angioedema gets admitted from the ER to his ICU. Its a nigh Expert Commentary. Tip for #1 - While 3-5 minutes of 100% oxygen is ideal to achieve denitrogenation, in an emergency 8 vital capacity breaths (maximal inhalation and exhalation) with a high FiO2 source is sufficient in a cooperative patient.. Tip for #2 - Airway edema is even worse in preeclamptic patients, and Mallampati scores acutely worsen DURING labor EMCrit is devoted to Maximally Aggressive Care: Maximally Aggressive Curative Care and Maximally » This blog & podcast for medical education on ED Intensive Care, Trauma, and Resuscitation. EMCrit 302 - Pain Management Update with Sergey Moto EMcrit EMwrap Trauma Cast Resus.me ER cast From the head of the bed Deranged Phys Uptodate -Tranexamic acid 1g/100mL NS over 10m followed by 1g over 8h -cooler 1: 4u group O Leuko reduced PRBC, 4u plasma 250 switch IVF to half normal saline with D5 to keep from blood glucose dropping too fast which would cause cerebral edem

emDOCs.net - Emergency Medicine EducationLife-threatening ..

3. Findings of the CRASH-2 Trial (1) CRASH-2 was a randomized, placebo-controlled trial that spanned 274 hospitals in 40 countries that sought to assess the effects of the early administration of a short course of tranexamic acid on death, vascular occlusive events, and the receipt of blood transfusion in trauma patients [].(2) Adult trauma (>16 years) patients with significant. The general range is 0.25-0.75 mcg/kg/min. Avoid its use in patients with creatinine clearance less than 50 mL/min. Because of its long onset of action and half-life, milrinone should be titrated every 2 hours (or slower, in the presence of renal disease). Vasopressin- Pressor. Mechanism of action

Dr. Axelson kicked off Grand Rounds this week with a look at DKA, hypercalcemia, suicide in the ED and more during M&M. Then we learned about Hereditary Angioedema, Thyroid Emergencies, Concussions, NIPPV and got a chalk talk about setting end goals of resuscitation from Dr. Dave Norton.& Apixaban side effects. Get emergency medical help if you have signs of an allergic reaction: hives; chest pain, wheezing, difficult breathing; feeling light-headed; swelling of your face, lips, tongue, or throat.. Also seek emergency medical attention if you have symptoms of a spinal blood clot: back pain, numbness or muscle weakness in your lower body, or loss of bladder or bowel control End of Academic Year 2019-2020. Academic Year 2018-2019 Click Here. Template. 8am - 9am M&M. 9am - 9:30am US Presentation or EKG/Image of the Week or Wellness / then Break. 9:30am - 10am Peds Half Hour or Journal Club. 10am - 11am Lecture 1 / Lecture 2. 11am - 12noon Foundations Cases or Lecture 3 / 4 April 2012 (1) Preoxygenation (2) Case Presentation-Hereditary Angioedema (3) HIV patients with headache Archived March 2012 (1) Bell's Palsy (2) Septic Arthritis (3) Risk Management - part I (4) Infections in the Elderly - part I (5) Risk Management - part II (6) Infections in the Elderly - part I

The Sequential Organ Failure Assessment (SOFA) score was developed using a consensus-based process by an expert committee of the European Society of Intensive Care Medicine in 1994 ( 34) ( Table VI ). It measures organ dysfunction in the same six systems as the MOD score, using a 5-point scale. Its major differences lie in the variable used to. The STAAMP trial is a multicenter, double-blind, placebo controlled randomized trial. A total of 447 patients were randomized to the TXA group and 456 to the placebo group. No statistically significant difference in 30-day mortality was found between the placebo group and TXA group (9.9 vs 8.1%; 95% CI 5.6-1.9%; p=0.17) Today's feed was full of excellent posts from a growing, diverse group of Tweeps leading to some lively conversations. Read on to see what we learned (by session/topic). Interestingly, of the Top 10 tweeters, numbers 9 and 10 (rfdsdoc and Precordialthump) with 100 tweets and a combined 297K impressions, are in an entirely different hemisphere. Talk about [

Angioedema - WikE

Histamine-mediated angioedema presents similarly to anaphylaxis, while bradykinin-mediated angioedema is slower in onset, more severe, and more commonly affects the oropharynx. Management should focus on the airway initially. Histaminergic-mediated angioedema can be treated with medications such as epinephrine, antihistamines, and steroids It seems every other week a trial about tranexamic acid (TXA) is published. Last month, the ULTRA trial was published in the Lancet. 955 patients with CT confirmed subarachnoid hemorrhage (SAH) were randomised to receive either TXA (1 gram iv bolus and 1 gram every 8 hours) or usual care

Provided by Alexa ranking, rebelem.com has ranked N/A in N/A and 9,414,189 on the world.rebelem.com reaches roughly 327 users per day and delivers about 9,803 users each month. The domain rebelem.com uses a Commercial suffix and it's server(s) are located in N/A with the IP number 35.202.7.245 and it is a .com. domain.. REBEL EM has primarily been a clinical blog focusing on critical appraisal. Academic Emergency Medicine. Diagnostic Accuracy of the HINTS Exam in an Emergency Department: A Retrospective Chart Review. A total of 2,309 patients met criteria for inclusion in the study. Physician uptake of the HINTS exam was high, with 450 (19.5%) dizzy patients receiving all or part of the HINTS

Podcast 67 - Tranexamic Acid (TXA), Crash 2, & Pragmatism with Tim Coats Feb 20, 2012 One of the most exciting and underutilized therapies for trauma is tranexamic acid (txa). EMCrit Wee - More on C-Spine Imaging Feb 17, 201 Help me fill in the blanks of the practice of ED Critical Care. In this podcast, we discuss all things related to the crashing, critically ill patient in the Emergency Department. Find the show notes at emcrit.org

In this episode we cover one of the hallmarks of the poisoned patient, that ECG tracing with a widening QRS. After reading the post, come listen for the nuances around all things hypertonic bicarb for sodium delivery, preventing acidosis with isotonic bicarb, how those sneaky-brilliant toxicologists will use lidocaine, and when to push the panic button on intra-lipid Definition (ICF-CY) Functions of moving food or liquid in the reverse direction to ingestion, from stomach to oesophagus to mouth and out, such as in gastro-esophegeal reflux, recurrent vomiting, pyloric stenosis. Definition (CCC) Expulsion of stomach contents through the mouth The MCHD Paramedic Podcast is a place for prehospital providers to discuss best practices and offer clinical insights relevant to our daily practice. MCHD Medical Directors Dr. Robert Dickson and Dr. Casey Patrick invite you to explore the many aspects of prehospital care. Along the way you can expect guest appearances by some of the brightest.