Tamingthesru
Transfusion in Trauma: One Ratio to Rule them All??
A couple weeks back we met for the first journal club of the year in our residency. For this first session, we tackled the clinical conundrum of transfusion ratios in trauma. The question came from a brainstorming session with the PGY-1 and 2 residents, where the following PICO question was derived:
Patients: Victims of both blunt and penetrating trauma in need of blood transfusion as a part of the their initial resuscitation
Intervention: high plasma and platelet to PRBC ratio transfusion
Comparison: low plasma and platelet to PRBC ratio transfusion
Outcome: Mortality (in patient and 30 day mortality)
Grand Rounds Recap - 9/17/2014
Radiation in Pregnancy with Dr. Polsinelli
Radiation effects can be deterministic or stochastic.
- Deterministic effects cause direct cell damage (radiation burns, teratogenicity, intrauterine death, genetic material damage). There is no evidence of teratogenicity in diagnostic testing radiation ranges (<50mGy). Genetic damage (causing effects in future generations) is theoretical and has not been reported. IUD is a concern, but on a population based scale there was no noted increase in incidence of fetal demise after large scale radiation event and this cannot be studied in vivo.
- Stochastic effects increase the probability of developing cancer. There is no minimum threshold and increasing dose increases probability. Risk of cancer noted to be ~5% if exposed to 1Gy of radiation. (for comparison maternal radiation is: chest xray = 0.1mGy; CT abd/pelvis 10mGy)
SMACC E.V.O
You may have heard of a little get-together happening in Chicago June 23-26th, 2015. And by little get-together I, of course, mean the biggest baddest Social Media and Critical Care Conference in existence coming to the U.S of A for the very first time. If you haven't heard of the SMACC conference, take a look at their conference webpage - http://www.smacc.net.au