April 20, 2014

Anticoagulation Reversal Part 2

In this episode…

  • Scott Weingart joins ERcast to give his take on 3 factor PCC and FEIBA.
  • A new technique for reducing mandibular dislocations.
  • Call for videos- Roberts and Hedges Clinical Procedures in Emergency Medicine
  • The ERCast rant off is just around the corner. Send us a 90 sec (or less) MP3 of your wisdom or vitrol.

Download Podcast Audio

 

A better way to reduce a mandibular dislocation?

Daniel Gromis has applied lessons learned from the Cunningham Technique for shoulder reduction and applied them to mandibular dislocations. One of the main hurdles in reducing a dislocated mandible is overcoming the spasm and force of the masseter muscle. By massaging the masseter and using a ‘casting’ type motion of the wrist, the Gromis Method may obviate the need for procedural sedation.

Roberts and Hedges Video Submission

Have a video you think would be a good fit for Roberts and Hedges Clinical Procedures in Emergency Medicine?

Click here to go to the submission page

 

More on FEIBA and PCC

International Journal of Emergency Medicine 2009  2:217–225 Activated prothrombin complex concentrate factor VIII inhibitor bypassing activity (FEIBA) for the reversal of warfarin-induced coagulopathy,”

Suboptimal effect of a three-factor prothrombin complex concentrate (Profilnine-SD) in correcting supratherapeutic international normalised ratio due to warfarin overdose. Transfusion. 2009;49:1171–7

Imberti D, Barillari G, Biasioli C, et al. Emergency anticoagulation reversal with a 3-factor prothrombin complex concentrates in patients with intracranial haemorrhage. Blood Transfus.2011;9:148–55.

First trauma study of 3-factor (profilnine SD on average 35 units/kg) showed good reversal of coagulopathy (J Trauma 2012;72(4):828)

This retrospective study is one of the first to show outcome benefit from PCC reversal  (Cerebrovasc Dis. 2011;31(2):170-6)

Rant off 2012

Is there something in emergency medicine or medicine in general that really gets your goat? Are your frothing at the mouth, just waiting for a chance to tell the world your take? Last year, rants ranged from the vitriolic, to educational, to philosophical. Last year’s Rant-Off can be heard here http://blog.ercast.org/2011/08/ercast-rant-off-2011/

Instructions:

1. Think of rant

2. Record rant. 90 seconds or less time limit. If you don’t have a microphone, a smartphone works great

3. Email your rant to  emergencypdx@gmail.com

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  1. [...] based on the Cunningham shoulder reduction technique using muscle relaxation.Dr. Rob Orman of ERCast fame had posted this initially on his site, and it’s too awesome of a trick for me not to [...]

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