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 987: Cough Suppressants

Episode 987: Cough Suppressants

Contributor: Meghan Hurley, MD Educational Pearls:  OTC Medications Dextromethorphan (DM) Most common OTC cough suppressant Minimal efficacy: Little evidence that it shortens the duration or severit...

15 Dec 20257min

Episode 986: Lateral Canthotomy in Emergency Settings

Episode 986: Lateral Canthotomy in Emergency Settings

Contributor: Taylor Lynch, MD Educational Pearls: What is orbital compartment syndrome, and how is it assessed in the emergency room? Orbital compartment syndrome (OCS) is an emergent ophthalmic cond...

8 Dec 20254min

Episode 985: Amiodarone vs. Lidocaine

Episode 985: Amiodarone vs. Lidocaine

Contributor: Aaron Lessen, MD Educational Pearls: How do amiodarone and lidocaine work on the heart? Amiodarone Blocks potassium channels (Class III effect). Also blocks sodium and calcium channels....

8 Dec 20252min

Episode 984: Fish Hooks

Episode 984: Fish Hooks

Contributor: Megan Hurley, MD Educational Pearls: Assess first: confirm the hook isn't near vital structures. Automatic subspecialty consult for eye involvement or proximity to carotid artery, radial...

24 Nov 20254min

Episode 983: Head-of-Bed Position in Large Vessel Occlusion Strokes

Episode 983: Head-of-Bed Position in Large Vessel Occlusion Strokes

Contributor: Aaron Lessen MD Educational Pearls:  Recent prospective randomized clinical trial assessed optimal head-of-bed positioning in patients with LVO 0º vs. 30º elevation Objective was to det...

18 Nov 20252min

Episode 982: Epistaxis Management

Episode 982: Epistaxis Management

Contributor: Meghan Hurley, MD Educational Pearls: 1. Initial Assessment Start with a physical examination: Determine if the bleed is anterior or posterior. Perform a primary survey: assess ai...

10 Nov 20256min

Episode 981: Electrical Burns

Episode 981: Electrical Burns

Contributor: Travis Barlock, MD Educational Pearls: Quick Statistics on Electrical Burns: Electrical burns compose roughly 2 to 9% of all burns that come into emergency departments. The majority of p...

3 Nov 20253min

Tox Talks 2025 Recap 1, Digoxin and Beta Blockers

Tox Talks 2025 Recap 1, Digoxin and Beta Blockers

Contributors: Preeya Prakash MD, Adam Greenhaw PharmD, Travis Barlock MD, and Jeffrey Olson MS4 In this episode, cardiologist Preeya Prakash and medical student Jeffrey Olson listen in as two cases ar...

29 Okt 202557min

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