Transfusion Reaction – Dr. Bayers

1. TRALI vs TACO
   1. TRALI more often febrile, more often low BP
   2. TACO very consistent with CHF exacerbation, likely preceding CHF.
2. Other Transfusion Reactions on the Differential
   1. Anaphylaxis
   2. Sepsis – Transfusion Transmitted
   3. Urticaria
   4. FNHTR
   5. AHTR – usually secondary to ABO incompatibility: send Coombs, recheck T&S, DIC, Haptoglobin

If Fever and no other symptoms: stop transfusion, give antipyretic, wait 30 minutes and continue transfusion

Research Overview – Dr. Huecker

Think Do Write

Be passionate

Research Louisville September

ACEP October

CORD March

AAEM April

SAEM May

IRB submission typically takes one month

Common IRB approved research:

-human subjects research

-quality improvement

-program evaluation

Utilize Jacob

-plan stats, charts, graphs, that you want back in a timely fashion. Give him time to complete

Tuberculosis – Dr. Matthew Keller

Most common symptom is cough

8 weeks for exposure testing

2-4 weeks of treatment of active TB before non-infectious

Active TB:

Symptomatic +ppd, +qfg, abnormal cxr, +sputum or culture -> RIPE

Latent TB Isoniazid x9 months

Don’t treat CAP with quinolone (especially) if TB is on ddx

Case Follow Up: Hyperviscosity syndrome – Dr. Slaven

Hyperviscosity syndrome

Features: fever, fatigue, headache, blurred vision, dyspnea, chest pain. polycythemia, thrombocytosis.

Mgt: Give IV fluids Consider phlebotomy.

Causes of fever other than obvious: Infection/Iatrogenic, Mets, AI, Drugs, Endocrine, Clots. (IMADEClots)

Case Follow Up: Febrile Neutropenia – Dr. Ferko

ANC <500 + fever

More than 80% hematologic malignancies. Often currently receiving chemo

Blunted immune response; not necessarily SIRS

COPD places into high risk category.

To be low risk category, everything needs to look good, including transportation and likelihood to follow up

Consider using MASCC Risk score

Admit: Cover pseudomonas, not necessary to start MRSA coverage unless:

Pneumonia

Not HDS

If MRSA suspected

Catheter or skin and soft tissue infection