EM:RAP

Who doesn’t love a brand-new fancy procedure? Ultrasound-facilitated catheter-directed fibrinolysis does sound like a fun new procedure to learn.
This month, Sanjay and Mike evaluate this study of ultrasound-facilitated catheter-directed fibrinolysis for intermediate-risk PE. The paper found a statistically significant reduction in a composite outcome compared to anticoagulation alone. However, the benefit is driven mainly by changes in a clinical scoring metric rather than meaningful differences in mortality or major clinical events.
Overall, the results are underwhelming and do not clearly support routine use of this intervention over standard anticoagulation with selective escalation.

When you hear that you have a pediatric trauma incoming, what’s your first thought?
As you prepare for the patient, you get your team ready and your resus bay set up, and you start to gather the medications you might need. You’ve done this countless times for adult patients, but you might need a refresher for the littlest patients coming through the door. This segment is just the ticket to increasing your confidence and knowledge on the latest thinking in pediatric resuscitation. Ilene is in conversation with Tom Kallay and Alex Schwed to discuss:
TXA, push-dose epi, balanced solutions, and more.

⚪✨PEARLS:
- Give patients blood early -
- TXA can be helpful in pediatric trauma patients
- Use normal saline in children with isolated head trauma who do not have an indication for blood resuscitation