G
Guest
We had a program at our hospital today that featured a world-reknowned trauma surgeon. I told him that I had seen well over a thousand people over the course of seven years and that I had never heard of anyone bleeding to death from a cut on the body, arm or leg. After giving it some thought, he said that he could not recall the causing death either.
He said that people do bleed to death from closed-head injuries and I agreed with that. The closest he could come to recalling someone bleeding to death from an injury was a woman who weighed at least 350 pounds. She had been in a car wreck did not seem very badly injured. However, she went into shock and died. She neglected to mention warfarin. An autopsy showed that she had bled under the layers of fat. That evidently kept them from noticing that she was bruising badly.
He said that if they know that somebody is on warfarin when they come in, them immediately give two units of fresh frozen plasma (vitamin K works too slowly). There is also something out now called recombinant Factor VII. This has been used for several years in hemophiliacs and is now being used on people with warfarin. The standard dose is two vials at $8,000.00 apiece for a total of $16,000.00. He said that his team was one of the first to report saving someone's life with this.
Here is the interesting part. He said that many tax-supported hospitals feel that this is too expensive to keep on hand. They can use the same amount of money to take care of many people with lesser needs. Even in hospitals that keep it on hand, so few people get it that when you compare patients with the same level of severity of injury between hospitals that use it and those that don't, the discharged alive rate is the same for both groups. So statistically you have just as good a chance at one hospital as the other, but what if you are the person who could benefit from it?
He said that people do bleed to death from closed-head injuries and I agreed with that. The closest he could come to recalling someone bleeding to death from an injury was a woman who weighed at least 350 pounds. She had been in a car wreck did not seem very badly injured. However, she went into shock and died. She neglected to mention warfarin. An autopsy showed that she had bled under the layers of fat. That evidently kept them from noticing that she was bruising badly.
He said that if they know that somebody is on warfarin when they come in, them immediately give two units of fresh frozen plasma (vitamin K works too slowly). There is also something out now called recombinant Factor VII. This has been used for several years in hemophiliacs and is now being used on people with warfarin. The standard dose is two vials at $8,000.00 apiece for a total of $16,000.00. He said that his team was one of the first to report saving someone's life with this.
Here is the interesting part. He said that many tax-supported hospitals feel that this is too expensive to keep on hand. They can use the same amount of money to take care of many people with lesser needs. Even in hospitals that keep it on hand, so few people get it that when you compare patients with the same level of severity of injury between hospitals that use it and those that don't, the discharged alive rate is the same for both groups. So statistically you have just as good a chance at one hospital as the other, but what if you are the person who could benefit from it?
