Successful Hemostasis by the use of Recombinant Factor VIIa in Uncontrolled Active Hemorrhage of Multiple Trauma Patients

PURPOSE: Uncontrolled bleeding is a leading cause of death in multiple-injury patients. It is very difficult to control hemorrhage due to microvascular injury in soft tissue by surgery or vascular intervention. Thus, hemostatic agents such as recombinant activated coagulation factor VII (rFVIIa) have become popular with regard to reducing transfusion volumes and correcting the hemorrhage-associated coagulopathy. METHODS: From March 2007 to January 2010 we used rFVIIa in 15 multiple-injury patients. Transfused packed red blood cell (pRBC) volume was compared before and 6 h after administration of rFVIIa. Complete blood count, prothrombin time and activated partial thromboplastin time were also checked. RESULTS: Mortality rate correlated strongly with initial severity of coagulopathy. Transfused pRBC volumes per hour were reduced significantly after rFVIIa (p=0.01), and coagulopathy was also significantly corrected. Thromboembolic events such as acute myocardial infarction and cerebrovascular attack, a fatal complication of rFVIIa, did not occur. CONCLUSION: The administration of rFVIIa can correct hemorrhage associated coagulopathy and reduce pRBCs transfusion volume. A quick decision regarding the administration of rFVIIa is needed for a more favorable outcome in multiple-injury patients with hemorrhagic shock.

Successful Hemostasis by the use of Recombinant Factor VIIa in Uncontrolled Active Hemorrhage of Multiple Trauma Patients

PURPOSE: Uncontrolled bleeding is a leading cause of death in multiple-injury patients. It is very difficult to control hemorrhage due to microvascular injury in soft tissue by surgery or vascular intervention. Thus, hemostatic agents such as recombinant activated coagulation factor VII (rFVIIa) have become popular with regard to reducing transfusion volumes and correcting the hemorrhage-associated coagulopathy. METHODS: From March 2007 to January 2010 we used rFVIIa in 15 multiple-injury patients. Transfused packed red blood cell (pRBC) volume was compared before and 6 h after administration of rFVIIa. Complete blood count, prothrombin time and activated partial thromboplastin time were also checked. RESULTS: Mortality rate correlated strongly with initial severity of coagulopathy. Transfused pRBC volumes per hour were reduced significantly after rFVIIa (p=0.01), and coagulopathy was also significantly corrected. Thromboembolic events such as acute myocardial infarction and cerebrovascular attack, a fatal complication of rFVIIa, did not occur. CONCLUSION: The administration of rFVIIa can correct hemorrhage associated coagulopathy and reduce pRBCs transfusion volume. A quick decision regarding the administration of rFVIIa is needed for a more favorable outcome in multiple-injury patients with hemorrhagic shock.

Does the General Public Comply with Hospital Guidance Conveyed at the Emergency Medical Information Center?

PURPOSE: This study investigated the compliance of the general public to the guidance conveyed by hospital emergency medical information centers. METHODS: This study included the incidences of inquiry on hospitals and clinics to Busan Emergency Medical Information Center by the general public for a 2-week period from January 4-17, 2009. Information obtained included general characteristics, time of hospital arrival and departure, length of hospitalization, hospitals visited, and treatment outcome. RESULTS: A total of 939 incidences of hospital guidance to the general public were examined. The degree of compliance was 71.2%, the ratio of the primary and secondary facility that the participants visited were 88.6% and 93.5% of the participants in this study were discharged from hospitals after their visit. Patients who complied with the information received displayed a shorter period of hospitalization than non-compliant patients. CONCLUSION: Emergency medical information centers may help ease the unnecessary use of emergency rooms by providing information on diseases to the general public and effectively distributing medical resources with guidance to proper hospitals according to the degree of symptoms.

Does the General Public Comply with Hospital Guidance Conveyed at the Emergency Medical Information Center?

PURPOSE: This study investigated the compliance of the general public to the guidance conveyed by hospital emergency medical information centers. METHODS: This study included the incidences of inquiry on hospitals and clinics to Busan Emergency Medical Information Center by the general public for a 2-week period from January 4-17, 2009. Information obtained included general characteristics, time of hospital arrival and departure, length of hospitalization, hospitals visited, and treatment outcome. RESULTS: A total of 939 incidences of hospital guidance to the general public were examined. The degree of compliance was 71.2%, the ratio of the primary and secondary facility that the participants visited were 88.6% and 93.5% of the participants in this study were discharged from hospitals after their visit. Patients who complied with the information received displayed a shorter period of hospitalization than non-compliant patients. CONCLUSION: Emergency medical information centers may help ease the unnecessary use of emergency rooms by providing information on diseases to the general public and effectively distributing medical resources with guidance to proper hospitals according to the degree of symptoms.