The World of Critical Care

aPTT vs Xa

The following episodes provides clarity on the use of aPTT vs Xa lab vales for determining levels of heparin activity. 

Heparin

The following episode begins the discussion of anticoagulation. The discussion includes the mechanism of action, routes of administration, dosing, initiation consideration, lab values (aPTT vs Xa), side effects, and reversal. The episode also examines the difference between heparin and low molecular weight heparin. 
 
For further reading:
https://emcrit.org/ibcc/heparin/
https://emcrit.org/ibcc/reverse/
https://emcrit.org/ibcc/thrombocytopenia/
 
 

Coagulation part two

The following episode specifically focuses on the role of platelets in coagulation. This episode builds upon the previous episode, which focused on the clotting cascade, with a detailed discussion of the formation of the platelet plug and its unique interaction with the fibrin mesh produced by the clotting cascade. The stage is now set for a discussion of anticoagulants. 

Clotting Cascade

The following episode provides a general overview of the clotting cascade. Focus is given to understanding terms such as clotting factors, zymogens, enzymes, cofactors, and proteases. Emphasis is given to understanding the extrinsic, intrinsic, and common pathway. Below are a list of helpful visual explanations of the clotting cascade I have found beneficial over the years. As always I appreciate any and all feedback on how to better this resource. 
Resources:
 
Blood Clotting Cascade
 
Activation of Coagulation Cascade
 
Hematology | Hemostasis: Coagulation Cascade
 
Coagulation cascade | Human anatomy and physiology | Health & Medicine | Khan Academy

Platelets

The following episode covers the basics of platelet administration in critical care. The episode focuses on the general function, measurement, and administration of platelets. Platelets have several unique administration requirements that need to be remembered! Next weeks episode will cover the clotting cascade and platelet function in much greater detail. Below are two valuable links to dive into the various causes of thrombocytopenia. 
Further reading:
https://emcrit.org/ibcc/thrombocytopenia/
Further listening:
https://podcasts.apple.com/us/podcast/the-intern-at-work-internal-medicine/id1338378584?i=1000414997402
 

Cryoprecipitate (Cryo)

The following episode covers the basics of cryoprecipitate (Cryo) use in critical care. The episode covers the formation of cryo, administration basics, common uses and indications. 

Fresh frozen plasma (FFP)

The following episodes covers the basics of FFP administration in critical care. 

Get the most out of your preceptor in the ICU

Packed red blood cells

PRBC's or packed red blood cells are one of the most common blood products administered in critical care. The following episode covers the importance of red blood cells, understanding hemoglobin and hematocrit levels, how lab levels are attained, some of the common reasons to transfuse, transfusion basics, and the critical transfusion associated complications. 

Ringer’s Lactate

Ringer's Lactate, lactated ringers, LR, Hartmann's solution are all terms used to describe this incredibly versatile crystalloid. The episode covers some of the indications and contra indications of LR administration with a brief overview of common misconceptions.