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ERCAST


Welcome to ERCast, a focused discussion on the questions, quagmires and known unknowns we face everyday in the emergency department.

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Jul 26, 2012

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.

Mandibular Dislocation Technique

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.

https://vimeo.com/46453741

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