Recombinant factor VIIa
 

Okay...

discussion at lunch today. Do SF medics carry this stuff with them...I said no way but my partner insists that they do and that they give it, on occasion, before going into "battle"...

any comments?

doc t.

That's a big negatory good buddy. SF Medics don't carry the stuff.
Nice to see you around DocT :cool:

Eagle

Now that I've done my google research . . .

Why isn't it carried and used? It looks as though it it would be helpfull. Or does it fall into that category of "can't use it enough to justify the space it takes up in the bag"?

Doc T - Now that I've Googled to find out what you were talking about - Why would an SF medic carry/use the stuff? What I read seems to imply it's for hemophilia or reversing an anticoagulant and doesn't look applicable to field trauma management. I'm not a medic/medical professional - I'm just curious! I'm interested because they pumped me full of Heperin during my MI and I've been on Plavix and 81mg ASA every since. Look at me hard and I bruise, cuts take a while to quit bleeding. Thank God, no Warfarin. So I've got a personal interest and questions about CAD, clotting factors, and IV coagulants in the event of traumatic injury. Peregrino

Ugh, hence the reason she placed it in here and not the weapons forum, so SF medics/Doc's could answer.... (and the reason she did't ask me.) :rolleyes:

Think of it as cross-training. I'm actually interested in the answer (when she gets finished with everything else she's responsible for). And I don't blame you for dodging the bullet. Us "knuckledraggers" gots to know our limits! :D Peregrino

Von Willebrands disease ?

I am a little curious why you would be on both Plavix and 81mg ASA. Do you have chronic Atrial fibrillation as well?

CAD - Coronary artery disease, heart attack while running PT. I'm one of the lucky ones, I survived. Now I get to take Plavix (and other things) forever. It reduces clotting so I have the other problems. Not much fun but it beats the alternative. Peregrino

J - Cause that's what the Cardiologist put me on. It's been reviewed and continued several times since so I have to assume there's a reason.

x

DD - Correct. I had mine put in three weeks before the drug coated stints became available. Apparently I wasn't a candidate for them anyway (size issue). And I'm very happy not to take rat poison the rest of my life (knock on wood). Course nobody has said yet if I should read some more about the recombinant Factor VII. :munchin Peregrino

Thank you for finally bringing this back to the topic.

BTW, last time I checked, Warfarin WAS the rodenticide, Coumadin, et al were the anti-coagulants.

TR

by my understanding They are the same thing, One being the generic equiv. of the other. I have been wrong though.

Good times,
blake

Coumadin is simply the brand name form of warfarin. Air .177 is correct.

Peregrino-

Check out these videos for some VERY specific presentations on the coagulation pathways and how they relate to administration of factor VIIa. Note: If you haven't already had physiology and some medical training these videos aren't for you.

trauma surgeon's perspective:

http://www.bloodline.net/stories/storyReader$3107

http://www.bloodline.net/stories/storyReader$3108

hematology researcher's perspective:

http://www.bloodline.net/stories/storyReader$3103

IMO, from reviewing this information, it isn't very reasonable to carry "on you". Having it in a trauma surgeon's tool bag in a nearby field trauma hospital might be nice though depending on your injuries.

Your plavix and Asa 81mg treatments both work to decrease initial platelet aggregation at the site. I don't see how factor VIIa would do much to "reverse" the complications from taking these meds. At best, it would help mitigate the effects by increasing other pathways involved in hemostasis after a major trauma.

FWIW, Factor VIIa does seem to have an important potential in advanced trauma management when treating patients who have had massive fluid resuscitation attempts as part of their management in the intial stabilization process. THAT seems to me very pertinant to this particular forum... maybe we can discuss this aspect and flush it out further. Perhaps this factor VIIa could be given at the initial triage facility(ex. base camp) and prevent the coagulopathy sometimes encountered after stabilization from beginning and provide less chance of subsequent complications.

Of course, for me to do this I would have to review all my old physiology info and combine it with what is discussed in the recent literature on this factor VIIa. Swatsurgeon or Doc T might be able to discuss in detail without having to dredge it up as they deal with these type issues daily. :munchin