Articles Tagged With: Hemorrhage
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Intrauterine Hemorrhage-Control Devices for Postpartum Hemorrhage
This multicenter, prospective, observational study comparing intrauterine balloon tamponade vs. vacuum-induced devices for postpartum hemorrhage demonstrated no difference in blood loss after device placement (median quantitative blood loss, 194 mL balloon vs. 240 mL vacuum; P = 0.40), need for blood transfusion (59.7% balloon vs. 50.0% vacuum; P = 0.08), need for more than three units of packed red blood cells (27.0% balloon vs. 24.9% vacuum; P = 0.53), or device failure (7.7% balloon vs. 8.5% vacuum; P = 0.70).
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Should Thrombolytic Drugs Be Added to Mechanical Thrombectomy in Acute Stroke?
Two recent trials from China studied the effect of post-thrombectomy, intra-arterial thrombolysis on neurological outcomes. One study used tenecteplase and the other used urokinase. Both studies showed a trend toward improvement that was not statistically significant, and there was an increase in brain hemorrhage. The benefit of adjunctive thrombolysis with mechanical thrombectomy is uncertain and requires more study.
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Placenta Accreta Spectrum Among Patients Seeking Abortion
Placenta accreta spectrum (PAS) in patients seeking abortions poses significant risks, especially for those with prior cesarean deliveries. PAS, often related to prior cesarean deliveries, increases abortion-related complications. Ultrasound is key for detection, but access to skilled care may be limited because of state-based abortion restrictions, leading to worse outcomes for affected patients.
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OB Emergencies Pose Patient Safety, Legal Risks
Patients with pregnancy complications presenting to EDs with little or no obstetric services may require transfer to another facility. This situation poses multiple risks for emergency physicians.
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Multicomponent Intervention for Early Detection and Treatment of Postpartum Hemorrhage: E-MOTIVE
This international, parallel, cluster-randomized trial assigned 80 secondary-level hospitals in four African countries to evaluate a multicomponent intervention for early detection and treatment of postpartum hemorrhage (PPH) vs. usual care following a vaginal birth. The intervention group had 60% less severe PPH cases (> 1 L blood loss) than the usual care cohort.
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Traumatic Hemorrhagic Shock
This issue will review the management of traumatic hemorrhage in the emergency department, highlighting prehospital care, recognition of hemorrhagic shock, initial resuscitative measures, massive hemorrhage protocol, reversal agents, and technological advancements in medical and mechanical support for traumatic hemorrhage.
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Failure to Inspect Patient After Cesarean Section Leads to Cardiac Arrests and Hysterectomy, $8 Million Award
This case serves as a stark reminder to medical professionals about the critical importance of closely monitoring patients after surgery and preparing to intervene promptly if complications arise. The incident underscores the significance of knowing the risks and potential complications associated with emergency cesarean sections.
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Long-Term Outcome in Patients with Intracerebral and Intraventricular Hemorrhage
Intracerebral hemorrhage continues to be a major cause of mortality and long-term disability. Early in the course of this severe disease prognosis is based on early characteristics, and care may be withdrawn at an early stage. The natural history and long-term recovery of survivors is uncertain because of withdrawal of care at an early time, resulting in a “self-fulfilling prophecy.”
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No Liability for Telemedicine Company or Hospital Over Stroke Treatment
This case confirms the importance of timely treatment and how providers can defend against claims of failure to provide such treatment. Frequently, a patient’s condition requires time-sensitive treatment, and the failure to do so may constitute medical malpractice if a similar physician under such circumstances would provide that timely care.
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Approaches to the Hemorrhaging Pediatric Trauma Patient
Clinicians might be surprised to learn that after central nervous system injury, hemorrhage/hemorrhagic shock is the second most common injury complex resulting in death for pediatric trauma patients. A thorough understanding of subtle presentations and management is essential to improve the outcome for these children.