Podcast 749: PCC for Me?

Podcast 749: PCC for Me?

Contributor: Nick Tsipis, MD

Educational Pearls:

  • Prothrombin complex concentrate (Kcentra) and Vitamin K are used to reverse life-threatening bleeds in patients on warfarin (Coumadin)
  • Factors II, VII, IX, and X are included in four-factor PCC
  • PCC/Kcentra dosing is 500-2000 units based on INR and patient weight
  • PROPER3 RCT was a non-inferiority trial done to evaluate standardized dosing of PCC/Kcentra versus variable dosing based on INR and weight
  • Looked at end-points to assess hemostasis, but ultimately this trial did not show non-inferiority of standardized dosing compared to variable dosing

References

Abdoellakhan RA, Khorsand N, Ter Avest E, et al. Fixed Versus Variable Dosing of Prothrombin Complex Concentrate for Bleeding Complications of Vitamin K Antagonists-The PROPER3 Randomized Clinical Trial. Ann Emerg Med. 2022;79(1):20-30. doi:10.1016/j.annemergmed.2021.06.016

Summarized by John Spartz, MS4 | Edited by Erik Verzemnieks, MD

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Episode 980: Brain Injury Guidelines (BIG)

Episode 980: Brain Injury Guidelines (BIG)

Contributor: Aaron Lessen, MD Educational Pearls: Traumatic Brain Injuries are a frequent complaint in the Emergency Department and have increased in recent years. The American Association for Surgery...

27 Loka 20253min

Episode 979: Oral vs Temporal Thermometers

Episode 979: Oral vs Temporal Thermometers

Contributor: Taylor Lynch, MD Educational Pearls: A recent study published in a pediatric journal in April 2025 compared temporal and oral thermometers Paired temperature measurements (temporal and o...

20 Loka 20253min

Episode 978: Delusional Parasitosis

Episode 978: Delusional Parasitosis

Contributor: Taylor Lynch, MD Educational Pearls: Delusional parasitosis is a subtype of the psychiatric condition delusional disorder Defined as a fixed, false belief of infestation by parasites or...

13 Loka 20253min

Episode 977: Amyloid Therapy and Stroke-like Events

Episode 977: Amyloid Therapy and Stroke-like Events

Contributor: Aaron Lessen, MD Educational Pearls: The cause of Alzheimer's disease is multifactorial, but the most widely suspected mechanism is the amyloid cascade hypothesis: Beta-amyloid proteins ...

6 Loka 20253min

Episode 976: Improvised Burr Hole in an Epidural Hematoma

Episode 976: Improvised Burr Hole in an Epidural Hematoma

Contributor: Alec Coston, MD Case Report Summary: A 17-year-old female involved in a motor vehicle collision presented to a rural emergency facility via personally operated vehicle. During workup and ...

29 Syys 20254min

Episode 975: Nursemaid's Elbow

Episode 975: Nursemaid's Elbow

Contributor: Aaron Lessen, MD Educational Pearls: What is a Nursemaid's Elbow? A condition in which an elbow gets partially pulled out of place (a radial head subluxation) Usually happens in kids und...

22 Syys 20253min

Episode 974: ACE Inhibitor Angioedema

Episode 974: ACE Inhibitor Angioedema

Contributor: Ricky Dhaliwal, MD Educational Pearls: Angioedema in anaphylaxis Histamine and mast cell-mediated pathway Treatment: First line: epinephrine for vasoconstriction and bronchodilation Se...

15 Syys 20255min

Emergency Medicine Cases with Dr. Barlock

Emergency Medicine Cases with Dr. Barlock

Contributors: Travis Barlock MD, Jeffrey Olson MS4 Feel free to use the cases below for your own practice. All of the scenarios are completely made up and designed to hit several teaching points. Case...

9 Syys 202553min

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