recent articles

practice updates

Thrombocytosis in the ED

Thrombocytosis can be related to a variety of diseases, with a range of presentations. What do you need to know in the ED about this condition?

practice updates

The Thromboelastogram (TEGĀ®): A Five-Minute Primer for the Emergency Physician

Thromboelastography is a mechanism of assessing coagulation based upon the viscoelastic properties of whole blood, and when compared to other coagulation assessments, this test allows for an assessment of near real-time, in-vivo clotting capacity. The point-of-care assay, which uses graphic interpretation of thromboelastography (the TEG), offers the opportunity for an expedited assessment of coagulopathies (thrombocytopenia, factor deficiency, heparin effect, hypofibrinogenemia, and hyperfibrinolysis). How can you use this modality in the ED? This post is full of pearls on interpreting TEG.

practice updates

Chronic Liver Disease and Hemostasis

Patients with chronic liver disease typically have elevated INRs and thromocytopenia. Thus, clinicians may believe that blood clots are not possible in this patient group. This is a brief review of hemostasis in liver disease and why blood clots can occur even with low platelet counts and elevated INRs.

practice updates

Blast Crisis: ED-focused management

Chronic myelogenous leukemia (CML) is a hematological malignancy that affects the leukocyte cell lineage. On occasion, a life threatening blast crisis can occur. CML is an important diagnosis for emergency physicians to be aware of so that they can manage complications that may occur. This is a brief review of CML and the management of several complications.

practice updates

Immune Thrombocytopenic Purpura: Pearls and Pitfalls

Immune Thrombocytopenic Purpura (ITP) is an immune-related cause of low platelet levels. It is more common in children than adults, but may occur in both populations. This is a brief review of the signs and symptoms of ITP and initial treatment options in the emergency department.

practice updates

DIC in the ED: What can you do about it?

Disseminated Intravascular Coagulation (DIC) is a serious complication of some critical illnesses. Patients are very ill and can present with a multitude of symptoms. While treatment of the underlying illness is key, there are some key interventions that can be initiated in the emergency department (ED). This is a brief review of the the underlying pathophysiology of DIC and the interventions that can be initiated in the ED.