Whole Blood - More than the Sum of Its Components?

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Whole Blood - More than the Sum of Its Components?

Q: For a patient in hemorrhagic shock from acute blood loss, what is the best resuscitative fluid?  

A: If they've lost blood, give them blood.  

It's never quite that simple though right?  For a generation now, we have practiced primarily by transfusing patient's with acute blood loss varying ratios of blood product components.  Thanks to the PROPPR trial, we most recently arrived on a generally accepted ratio of 1:1:1 for Plasma, Platelets, and Red Blood Cells for severely injured bleeding trauma patients.  Recent military literature however, suggests that there may be another strategy (which is in and of itself a bit of a throwback) that could offer additional benefits over a component transfusion strategy.  If were are trying to recreate a whole blood with a 1:1:1 plasma:platetel:PRBC ratio, why not just give whole blood?

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Grand Rounds Recap 1.10.18

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Grand Rounds Recap 1.10.18

Grand rounds this week started off with a review of the EMTALA law with Dr. Hinckley, as well as some case discussion.  This was followed by a presentation from our clinical pharmacists, PharmD's Nicole Harger and Madeline Stephens, on anti-epileptic medications and their uses, as well as an update on our medication supplies in the ED.  Drs. Murphy-Crews and Scanlon then presented their evidenced based algorithm for the management of STEMI, followed by our combined peds EM lecture with Dr. Kevin Overmann on the evaluation of the pale child and pediatric anemia.  This was followed by Dr. Ludmer's R4 case follow up/best of residency cases.  The day finished up with Dr. Sim Mand presenting her clinical diagnostics lecture on the assessment and management of the non-pregnant patient with abnormal uterine bleeding. 

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