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Emergency Blood transfusion

Luca Pierelli, Michele Vacca, Gina Zini, Maddalena Maresca, Giacomo Menichella, Susanna Santinelli, Maria Alba Stigliano, Gabriele Mandarello, Roberto Gasbarri, Stefania Vaglio
Between September 15 and November 11, 2017, the area of Rome was subjected to cessation of donation in an area of approximately 1,300,000 inhabitants and with a 5-day quarantine for the rest of metropolitan areas due to Chikungunya virus (CHIKV) outbreak. Quarantine was applied to red blood cell (RBC) and plasma units while platelet concentrates (PCs) were subjected to pathogen inactivation methods (PIMs). Quarantine was based on an active recall of all donors and, in case of declared absence of any symptom or illness, on release of RBC and plasma units after 5 days...
October 13, 2018: Transfusion
Christopher J Goodenough, Tyler A Cobb, John B Holcomb
Resuscitative endovascular balloon occlusion of the aorta (REBOA) has become an increasingly popular alternative to emergency thoracotomy and aortic cross-clamping in patients with exsanguinating hemorrhage.1 This new capability is increasingly being used in non-trauma situations.2 3 This report demonstrates another novel use of REBOA for iatrogenic intra-abdominal hemorrhage. An 83-year-old man with multiple medical comorbidities and a history of chronic mesenteric ischemia was admitted to our institution for an elective mesenteric revascularization...
2018: Trauma surgery & acute care open
José-Gabriel Sato Folatre, Per Arnell, Mari Henning, Kristina Josefsson, Gabriel Skallsjö, Sven-Erik Ricksten
In 2016, physician staffed helicopter emergency medical service (VGR HEMS) became the first Swedish prehospital service to routinely carry and transfuse red blood cells. In this report we describe our implementation and present our results, with preliminary analysis of our data. Out of 1 336 patients a total of 34 patients (2,5 %) were transfused without any adverse events. Our demography is predominantly male and the most common mechanism of injury is trauma. Amongst the most common interventions were endotracheal intubation, thoracostomy and CPR...
October 2, 2018: Läkartidningen
Naga Sk Patibandla, Dulabh K Monga
Ovarian cancer is the second most common and the most lethal gynecological malignancy in the western world. Unfortunately, there are lack of methods for early screening and diagnosis of the disease. Because of this, most of the cases are diagnosed at an advanced stage and have poor prognosis. The standard treatment of ovarian cancer is maximal cytoreductive surgical debulking followed by platinum-based chemotherapy. There are new molecular agents available for maintenance therapy of ovarian cancer including anti-angiogenic therapies, poly adenosine diphosphate ribose polymerase inhibitors, inhibitors of growth factor signaling, or folate receptor inhibitors, as well as several immunotherapeutic approaches...
October 6, 2018: Journal of Oncology Pharmacy Practice
John R Hess
BACKGROUND: The Cascadia subduction zone off the US Pacific Northwest coast produces a Force 9 earthquake once every 300 years. Cascadia Rising was a regional disaster drill modeled on such an event. Western Washington State has 5 million people and one Level I trauma center. STUDY DESIGN AND METHODS: The blood response of the trauma center and region were modeled under the conditions laid down in the disaster scenario. The scenario assumed structural damage to the 1931 reinforced concrete building housing the trauma hospital transfusion service with loss of electricity, data services, and water...
October 6, 2018: Transfusion
Mingliang Lu, Gang Sun, Xiao-Mei Zhang, You-Qing Xv, Shi-Yao Chen, Ying Song, Xue-Liang Li, Bin Lv, Jian-Lin Ren, Xue-Qing Chen, Hui Zhang, Chen Mo, Yan-Zhi Wang, Yun-Sheng Yang
BACKGROUND This study aimed to discover the common cause of non-variceal upper-gastrointestinal bleeding (NVUGIB) by conducting a multi-center retrospective study from 2008 to 2012. MATERIAL AND METHODS Hospitalized patients ages ≥18 years old, from 8 hospitals in China, diagnosed with NVUGIB by endoscopy from 1 January 2008 to 31 December 2012 were enrolled. Questionnaires were developed and a data-entry graphical user interface was designed by using EpiData software. RESULTS Total of 2977 hospitalized patients from 8 medical centers were included...
October 6, 2018: Medical Science Monitor: International Medical Journal of Experimental and Clinical Research
Dou-Sheng Ba, Chi Zhang, Sheng-Jie Jin, Ping Chen, Guo-Qing Jiang
BACKGROUND/AIMS: In patients who survive the first esophageal variceal bleeding (EVB) resulting from portal hypertension, the probability of fatal esophageal variceal re-bleeding (EVR) is high. We have developed a sandwich-style sequential therapy combining laparoscopic splenectomy and azygoportal disconnection (LSD) with preoperative and postoperative endoscopic intervention (LSDE). The aim of the present study was to investigate whether LSDE is safe and effective and to evaluate whether the postoperative EVR rate for LSDE was lower than that for LSD without periodical postoperative endoscopic intervention (NLSDE)...
October 5, 2018: Turkish Journal of Gastroenterology: the Official Journal of Turkish Society of Gastroenterology
Hideyuki Chiba, Ken Ohata, Jun Tachikawa, Jun Arimoto, Keiichi Ashikari, Hiroki Kuwabara, Michiko Nakaoka, Toru Goto, Atsushi Nakajima
BACKGROUND: Endoscopic submucosal dissection (ESD) is an effective treatment for early-colorectal cancer. Although delayed bleeding is a serious potential complication, there is no consensus on the optimal protocol to determine which cases require emergency colonoscopy. AIMS: This study aimed to assess the risk factors for delayed bleeding after ESD and evaluate the "watch and wait" strategy for delayed bleeding. The "watch and wait" strategy was used for delayed bleeding, unless the shock index was ≥ 1 and/or a moderate amount of hematochezia occurred more than five occurrences...
October 3, 2018: Digestive Diseases and Sciences
Yoshifumi Morita, Takanori Sakaguchi, Ryo Kitajima, Satoru Furuhashi, Ryota Kiuchi, Makoto Takeda, Takanori Hiraide, Yasushi Shibasaki, Hirotoshi Kikuchi, Yuji Suzuki, Kei Tsukamoto, Tomoharu Matsuura, Hiroya Takeuchi
Pancreatic cancer often invades the duodenum and causes obstruction, but rarely causes massive duodenal bleeding. A 68-year-old male was admitted to our hospital because of vomiting. Enhanced abdominal CT showed a hypovascular tumor with air bubbles in the uncinate process of the pancreas. The tumor invaded the duodenum and metastasized to the liver and peritoneum. The main trunk of the superior mesenteric artery (SMA) was circumferentially involved. After admission, he had hematemesis and melena. Emergency gastroduodenoscopy revealed pulsating vessels in the third portion of the duodenum and he eventually experienced hemorrhagic shock...
May 2018: Case Reports in Gastroenterology
J A Loughran, T L Kitchen, S Sindhakar, M Ashraf, M Awad, E J Kealaher
Amniotic fluid embolism is a rare but often catastrophic emergency. The non-specific clinical features and lack of diagnostic tests make it a diagnosis of exclusion. Point-of-care visco-elastometric testing is being increasingly used during obstetric haemorrhage. We present a case of amniotic fluid embolism, diagnosed and managed using rotational thromboelastography. During a precipitous labour, a 21-year-old multiparous woman became pale, distressed and disorientated. The fetus was delivered using forceps...
September 11, 2018: International Journal of Obstetric Anesthesia
Wei Ming Ng, Wei Feng Lee, Si Oon Cheah, Yan Ee Lynette Chung, Chan Yu Lee, Beng Leong Lim
Peri-mortem caesarean section (PMCS) is a very rare procedure performed to improve the chances of survival for both mother and fetus following cardiorespiratory arrest. Non-obstetricians including Emergency Physicians (EPs) are often called upon to perform this procedure under challenging and suboptimal circumstances. We reported a case of PMCS performed timely after traumatic cardiorespiratory arrest that resulted in fetal survival. A 25-year-old primigravida female and six-month pregnant presented to the Emergency Department (ED) of an adult tertiary hospital...
August 30, 2018: American Journal of Emergency Medicine
M Dargère, M-L Langlais, C Gangloff, C Léostic, C Le Niger, Y Ozier
Haemorrhagic shock is a rare occurrence in emergency medicine but it can be associated with significant mortality. The purpose of this study was to evaluate the impact of a major haemorrhage protocol on patient management in Emergency Department Resuscitation Area. METHODS: A single-centre study was conducted to compare two periods, before and after institution of a massive haemorrhage protocol including the use of massive transfusion orders and the availability of packed red blood cell concentrates prior to patient's admission...
September 12, 2018: Transfusion Clinique et Biologique: Journal de la Société Française de Transfusion Sanguine
Ashutosh Lal, Trisha E Wong, Jennifer Andrews, Vinod V Balasa, Jong H Chung, Craig M Forester, Alan K Ikeda, Siobán B Keel, Monica B Pagano, Geetha Puthenveetil, Sanjay J Shah, Jennifer C Yu, Elliott P Vichinsky
BACKGROUND: The severe forms of thalassemia are the most common inherited anemias managed with regular blood transfusion therapy. Transfusion policies and complications are critical to quality of life and survival, but there is a lack of standardized care. STUDY DESIGN AND METHODS: A survey of 58 items was completed in 2016 by 11 centers in California, Washington, Oregon, Nevada, and Arizona providing long-term care for thalassemia. The questionnaire addressed demographic information, transfusion practices and complications, and educational needs...
September 27, 2018: Transfusion
Elina Huerfano, Alejandro Gonzalez Della Valle, Kate Shanaghan, Federico Girardi, Stavros Memtsoudis, Jiabin Liu
Background: Acute care events including emergency department (ED) visits and unscheduled inpatient re-admissions following lower-extremity arthroplasty are not fully understood. Question/Purposes: The purpose of this study was to characterize acute care events occurring after discharge in patients who received a lower-extremity arthroplasty: the incidence, timing, and risk factors of inpatient admission and ED visits within 90 days of discharge. Methods: The New York State Inpatient and Emergency Department Databases were used to identify patients who underwent elective total knee arthroplasty (TKA) or total hip arthroplasty (THA) from 2009 to 2013 (124,234 and 76,411 patients, respectively)...
October 2018: HSS Journal: the Musculoskeletal Journal of Hospital for Special Surgery
Tinna Baldvinsdóttir, Marie Blomberg, Caroline Lilliecreutz
OBJECTIVE: Postpartum haemorrhage (PPH) is the most common obstetric emergency. A well-established postpartum haemorrhage protocol in the labour ward is crucial for effective treatment. The aim of the study was to investigate if practical obstetric team training improves the patient outcome and clinical management of PPH. SETTING: The practical obstetric team training (PROBE) at Linköping University Hospital, Sweden, with approximate 3000 deliveries annually, was studied between the years of 2004-2011...
2018: PloS One
Dr Ishu Bishnoi, Dr Vikram Saini, Dr Pallavi Chugh, Dr Sheikhoo Bishnoi, Dr Geetika Duggal, Dr Anamika Adib
INTRODUCTION: Treatment of AVMs is, nowadays, performed at specialized neurosurgical centers, which are well equipped with microscope with green filter, neurosurgical cath-lab and experienced neurosurgeons team. The patients diagnosed with AVMs at smaller hospitals should be referred to such hospitals. But what happens when a neurosurgeon has to face the unavoidable worst case scenario, i.e., emergency unplanned surgical excision of undiagnosed, ruptured AVM with large hematoma. This case report is about management of such case...
September 21, 2018: World Neurosurgery
Barış Gülcü, Tuncay Yılmazlar, Özgen Işık, Ersin Öztürk
OBJECTIVES: The incidence of colorectal cancer becomes higher among octogenarians as the life expectancy increases. Whether advanced age is a risk factor for colorectal surgery is a matter of debate. In the present study, the clinical results of octogenarians who underwent colorectal cancer surgery are discussed to find an answer to this question. MATERIAL AND METHODS: Data of 63 octogenarians who were operated in a tertiary colorectal surgery department between January 1, 2010 and December 31, 2013 were reviewed retrospectively...
September 18, 2018: Turkish Journal of Surgery
Luigi Fiocca, Alberto F Cereda, Chiara Bernelli, Paolo A Canova, Federica Serino, Tullio Niglio, Giuseppe Musumeci, Giulio Guagliumi, Angelina Vassileva, Michele Senni, Orazio Valsecchi
BACKGROUND: Iatrogenic hemorrhagic pericardial tamponade (IHPT) represents a life-threating condition requiring emergency pericardiocentesis. In this clinical context, reinfusion of pericardial blood can stabilize the patient and sustain hemodynamic conditions. AIMS AND METHODS: We reviewed all cases of IHPT occurred at our hospital over a 10 years span. In all patient autologous blood reinfusion through a femoral vein was performed. RESULTS: In our clinical experience of 30 consecutive patients with hemorrhagic cardiac tamponade, this technique was successful to limit blood transfusions, to prevent further clinical worsening and bridge patients with intractable bleeding, to cardiac surgery...
September 23, 2018: Catheterization and Cardiovascular Interventions
Thomas Banister, Josesph Spiking, Lakshmana Ayaru
Objective: To use an extended Glasgow-Blatchford Score (GBS) cut-off of ≤1 to aid discharge of patients presenting with acute upper gastrointestinal bleeding (AUGIB) from emergency departments. Background: The GBS accurately predicts the need for intervention and death in AUGIB, and a cut-off of 0 is recommended to identify patients for discharge without endoscopy. However, this cut-off is limited by identifying a low percentage of low-risk patients. Extension of the cut-off to ≤1 or ≤2 has been proposed to increase this proportion, but there is controversy as to the optimal cut-off and little data on performance in routine clinical practice...
2018: BMJ Open Gastroenterology
Debra Berry, Margaret DiGuardo, Yunchuan Delores Mo, Gay Wehrli
BACKGROUND: The blood bank and transfusion medicine services (BBTMS) engages with electronic health records (EHRs), clinicians, and outside hospitals (OHs) to obtain comprehensive patient history to optimize care. Detection of anti-D in a pregnant patient underscores this work. Differentiating passive anti-D due to RhIG administration versus alloanti-D affects clinical decision making. The objectives of this study were to identify the required steps, barriers, and outcomes of anti-D investigations in obstetric patients...
September 19, 2018: Transfusion
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