Discover and read the best of Twitter Threads about #hemorrhage

Most recents (6)

1/

Second day of @Smart_Meeting_M

Professor @giovannilandoni talking about management of #anticoagulant in #perioperative patients 💉

✅You surely all know how to deal with #antithrombotic and #regionalanesthesia, here the guidelines:

pubmed.ncbi.nlm.nih.gov/34980845/

#FOAMed #FOAMcc Image
2/

💡Let's focus on perioperative #DOAC /#NOAC / #TSOAC

➡️Consider both #surgical blood loss risk and #patient characteristics.

⚠️Remember NOT to bridge with #LMWH or #UFH.

pubmed.ncbi.nlm.nih.gov/33895845/ Image
3/

What if it's not an elective patient??

Use #reversal agents when needed❗

🔹#Idarucizumab for #dabigatran
🔹#Andexanet for #apixaban and #rivaroxaban
💡#Prothrombin complex concentrates in addiction

pubmed.ncbi.nlm.nih.gov/36988142/ Image
Read 7 tweets
Intravenous #thrombolysis (IVT) may be safe in patients taking direct oral anticoagulants (DOACs)

1. DOACs, including apixaban, dabigatran and rivaroxaban, have emerged as the primary #stroke prevention option in patients with nonvalvular atrial fibrillation (AF).
#neurotwitter
2. Every sixth patient with stroke otherwise qualifying for intravenous thrombolysis has a prescription for DOACs. Guidelines recommend the exclusion of patients with recent ingestion of DOACs (within 48 hours previously) from receiving IVT should they have an ischemic stroke.
3. This recommendation to exclude patients on DOACs from receiving IVT is based on the presumption of an increased risk of symptomatic intracranial #hemorrhage (sICH), but data to support or refute this presumption are lacking.
Read 10 tweets
1a) Welcome to a new #accredited #tweetorial on the management of aFXa-DOAC-associated #hemorrhage and specifically the role of coag laboratory testing in these challenging cases.
1b) Our expert author is #pharmacist Craig Beavers, PharmD @beaverspharmd CV Clinical Pharmacy Specialist @UK_COP, and Immediate Past Chair of the @ACCinTouch #ACCCVT Section
2) This 🆓program is accredited for 0.5h CE/#CME for #physicians #physicianassociates #nurses #nurespractitioners #pharmacists and is supported by a grant from AstraZeneca. See statement of accreditation and faculty disclosures at cardiometabolic-ce.com/disclosures/.
Read 37 tweets
1) Welcome to a #tweetorial on what every #ICU #nurse should know about #hypertensive crisis, or #hypertensive #emergency as it is now more properly termed. I’m Bryan Boling @bryanboling, ICU #NP, & co-host of the @icuscenarios podcast. Follow this 🧵for 🆓CE/#CME credit!
2) This accredited educational activity is intended for healthcare providers & is supported by grants from AstraZeneca, Bayer, & Chiesi. Faculty disclosures cardiometabolic-ce.com/disclosures/. Like ❤️this topic? More CE/#CME on #hypertension mgt at cardiometabolic-ce.com/category/hyper….
3) So let's start with a case: 65yo ♂️, presents to the #ED with #headache, lethargy & confusion. PMH: #HTN, #hyperlipidemia, #DM2, COPD. Initial VS: HR 85, BP 205/120, T 37.2 RR 12, SpO2 92% on RA. Family reports that he has been more lethargic over the past 2 days.
Read 37 tweets
#WeekendLecture
Intracranial Atherosclerotic Disease #ICAD

#ICAD leads to changes ranging from minor wall thickening to #hemodynamically significant luminal stenosis and is one of the most #common causes of #stroke worldwide
ahajournals.org/doi/10.1161/CI…

🧵 Image
#WeekendLecture
#ICAD

✅10% of stroke, based on autopsy studies
bit.ly/3v6Lhrd
✅More prevalent in #African Americans, #Hispanics, and #Asians as compared with whites
bit.ly/3AuSiDt

Other risk factors in table Image
#WeekendLecture
#ICAD

In postmortem studies
👉degree of luminal #stenosis
👉% of the plaques containing >40% #lipid area
👉prevalence of intraplaque #hemorrhage, #neovasculature and #thrombus,
were higher in those #plaques associated with #infarct
🔹karger.com/Article/Abstra… Image
Read 13 tweets
Let's focus again on potentially preventable death from torso #hemorrhage.

Our paper in @ShockJournal highlighted the need to refocus our efforts on the prehospital setting (🧵here: )

But can we ID those patients successfully who might need ARC? 🧵
2/
We attempt to do so in this paper published in @JTraumAcuteSurg

Link here: journals.lww.com/jtrauma/Abstra…

Thanks to lead author @AhmerIrfanMBChB and coauthors at @uabmedicine for their hard work Image
3/
To recap: Advances of in-hospital care have been profound over the last >3 decades-those reaching alive & not in irreversible shock has a v reasonable survival chance.

A subset of patients (as high as 45% in some series) die in the field or w/i 1 hour of hospital arrival
Read 19 tweets

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