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outrider
medicine forum Guru
Joined: 28 Apr 2005
Posts: 1155
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 Posted: Thu Jun 09, 2005 11:37 am Post subject:
clotting agent shows promise with worst strokes
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Clotting agent shows promise with worst strokes
By ANDRÉ PICARD
Thursday, June 9, 2005 Page A17
PUBLIC HEALTH REPORTER
http://www.theglobeandmail.com/servlet/ArticleNews/TPStory/LAC/20050609/HSTROKE09/TPHealth/
In mid-March, Dennis Woon was teaching a class in petroleum engineering
at the University of Calgary when he started losing feeling in his
right leg.
Thinking the leg had just fallen asleep, he carried on. As he chatted
with students after class, the numbness spread and he began listing on
his chair. Mr. Woon insisted he was just tired: "I didn't have any
pain. I didn't have a headache. So I didn't think it was a big deal."
But one of his students, recognizing key symptoms of a stroke,
paralysis and loss of balance, dialled 911.
Within minutes, the 55-year-old was on his way to Foothills Medical
Centre. A CT scan revealed that he was suffering from an intracerebral
hemorrhage, the most deadly form of stroke, and a condition for which
there is no treatment. As it turns out, however, the Calgary hospital
was part of a trial testing the use of Factor VIIa, a clotting factor
used by some hemophiliacs to treat bleeding in the brain just like Mr.
Woon was suffering.
Treatment with Factor VIIa cut the death rate by 30 per cent, and
resulted in 10 per cent more patients recovering fully from stroke.
"The results were quite promising," Dr. Andrew Demchuk, director of the
stroke program at Foothills, said in an interview. The numbers are
impressive, he said, considering that 40 per cent of people who suffer
an intracerebral hemorrhage usually die within 48 hours, and double
that number suffer lasting disability.
-----snip------ |
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Guest
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| Posted: Thu Jun 09, 2005 3:04 pm Post subject:
Re: clotting agent shows promise with worst strokes
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"zee" <outrider@despammed.com> wrote in message
news:1118324253.707019.266460@g14g2000cwa.googlegroups.com...
Clotting agent shows promise with worst strokes
unfortunately not all "strokes" are from bleeding....many if not most..are
from a "clot" occluding a major vessel
thus adminstering a "clotting agent" would surely make the situation far
worse...
thrombolytics...those meds used in acute heart attacks..are also being used
in acute strokes...with excellent results...the clot is dissolved,,blood
flow is restored...etc
perhaps the title of this article is misleading..it should read "bleeding in
the brain,,etc"
all strokes..in fact..not even most strokes are bleeding..
By ANDRÉ PICARD
Thursday, June 9, 2005 Page A17
PUBLIC HEALTH REPORTER
http://www.theglobeandmail.com/servlet/ArticleNews/TPStory/LAC/20050609/HSTROKE09/TPHealth/
In mid-March, Dennis Woon was teaching a class in petroleum engineering
at the University of Calgary when he started losing feeling in his
right leg.
Thinking the leg had just fallen asleep, he carried on. As he chatted
with students after class, the numbness spread and he began listing on
his chair. Mr. Woon insisted he was just tired: "I didn't have any
pain. I didn't have a headache. So I didn't think it was a big deal."
But one of his students, recognizing key symptoms of a stroke,
paralysis and loss of balance, dialled 911.
Within minutes, the 55-year-old was on his way to Foothills Medical
Centre. A CT scan revealed that he was suffering from an intracerebral
hemorrhage, the most deadly form of stroke, and a condition for which
there is no treatment. As it turns out, however, the Calgary hospital
was part of a trial testing the use of Factor VIIa, a clotting factor
used by some hemophiliacs to treat bleeding in the brain just like Mr.
Woon was suffering.
Treatment with Factor VIIa cut the death rate by 30 per cent, and
resulted in 10 per cent more patients recovering fully from stroke.
"The results were quite promising," Dr. Andrew Demchuk, director of the
stroke program at Foothills, said in an interview. The numbers are
impressive, he said, considering that 40 per cent of people who suffer
an intracerebral hemorrhage usually die within 48 hours, and double
that number suffer lasting disability.
-----snip------ |
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Robert
medicine forum Guru
Joined: 28 Apr 2005
Posts: 1700
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| Posted: Thu Jun 09, 2005 3:35 pm Post subject:
Re: clotting agent shows promise with worst strokes
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<Hawki63@sbcglobal.net> wrote in message
news:8E_pe.26132$J12.2460@newssvr14.news.prodigy.com...
| Quote: |
That is correct on your comments. |
We have been using Novoseven for years. That is old news.
The original indications were for factor VIII inhibitors (antibodies) in
correcting coagulopathies.
The majority of the time we use it on massive trauma patients and it has
even been used on coumadin induced bleeding.
It is very expensive. One small vial costs about $ 1200 if I remember
correctly.
The advantage in massive traumas is that the need for more many blood units
is reduced and thus save the blood supply.
I have personally called the doctor and advised him on many occasions of
that option. |
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Guest
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| Posted: Thu Jun 09, 2005 4:37 pm Post subject:
Re: clotting agent shows promise with worst strokes
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"Robert" <Robertitsme@hotmail.com> wrote in message
news:qLednSI-GY1p4DXfRVn-sg@got.net...
| Quote: |
Hawki63@sbcglobal.net> wrote in message
news:8E_pe.26132$J12.2460@newssvr14.news.prodigy.com...
That is correct on your comments.
We have been using Novoseven for years. That is old news.
The original indications were for factor VIII inhibitors (antibodies) in
correcting coagulopathies.
The majority of the time we use it on massive trauma patients and it has
even been used on coumadin induced bleeding.
It is very expensive. One small vial costs about $ 1200 if I remember
correctly.
The advantage in massive traumas is that the need for more many blood
units
is reduced and thus save the blood supply.
I have personally called the doctor and advised him on many occasions of
that option.
|
good for you Robert!!! are you an ER nurse???
actually the stats on strokes say 90% are clots...so introducing a clotting
agent is NOT a smart idea!! esp since the thrombolytics need to be given
within hours of onset....
I surely can see the use of anti clotting agents in the situations you
describe....continue to keep the docs up to date!!!
amazing how often "we nurses" read more journals,,etc than the docs... |
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Robert
medicine forum Guru
Joined: 28 Apr 2005
Posts: 1700
|
| Posted: Thu Jun 09, 2005 6:02 pm Post subject:
Re: clotting agent shows promise with worst strokes
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<Hawki63@sbcglobal.net> wrote in message
news:y%%pe.26408$J12.13396@newssvr14.news.prodigy.com...
| Quote: |
"Robert" <Robertitsme@hotmail.com> wrote in message
news:qLednSI-GY1p4DXfRVn-sg@got.net...
Hawki63@sbcglobal.net> wrote in message
news:8E_pe.26132$J12.2460@newssvr14.news.prodigy.com...
That is correct on your comments.
We have been using Novoseven for years. That is old news.
The original indications were for factor VIII inhibitors (antibodies) in
correcting coagulopathies.
The majority of the time we use it on massive trauma patients and it has
even been used on coumadin induced bleeding.
It is very expensive. One small vial costs about $ 1200 if I remember
correctly.
The advantage in massive traumas is that the need for more many blood
units
is reduced and thus save the blood supply.
I have personally called the doctor and advised him on many occasions of
that option.
good for you Robert!!! are you an ER nurse???
|
No I protect the blood supply in the blood bank and all Novoseven is issued
by us. I am licensed as a clinical laboratory scientist. National
registration MT(ACSP).
| Quote: |
actually the stats on strokes say 90% are clots...so introducing a
clotting
agent is NOT a smart idea!! esp since the thrombolytics need to be given
within hours of onset....
|
As you state it is contra indicated in thrombotic conditions including DIC.
It is a rapid reversal in comparison to fresh frozen plasma. You need an
acute diagnosis obviously before it should be given.
| Quote: |
I surely can see the use of anti clotting agents in the situations you
describe....continue to keep the docs up to date!!!
|
Like anything out there that is new it starts with one use and people obtain
experience with it and then people start using it for other conditions. FDA
approval is still limited in use although clinical studies have expanded the
use.
It is used by trauma surgeons at our institution. Doctors in other
departments are urged to contact the trauma surgeons for their experience.
If you have 2 O neg units in the fridge and the patient has used already
used 10 or if the patient has used 20 units then it is time for some sort of
intervention.
| Quote: |
amazing how often "we nurses" read more journals,,etc than the docs...
I have some funny stories I have seen involving doctors that I would rather |
not mention here....... |
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Guest
|
| Posted: Thu Jun 09, 2005 7:52 pm Post subject:
Re: clotting agent shows promise with worst strokes
|
|
|
"Robert" <Robertitsme@hotmail.com> wrote in message
news:gP2dnYyhLrQQPTXfRVn-tg@got.net...
| Quote: |
Hawki63@sbcglobal.net> wrote in message
news:y%%pe.26408$J12.13396@newssvr14.news.prodigy.com...
"Robert" <Robertitsme@hotmail.com> wrote in message
news:qLednSI-GY1p4DXfRVn-sg@got.net...
Hawki63@sbcglobal.net> wrote in message
news:8E_pe.26132$J12.2460@newssvr14.news.prodigy.com...
That is correct on your comments.
We have been using Novoseven for years. That is old news.
The original indications were for factor VIII inhibitors (antibodies)
in
correcting coagulopathies.
The majority of the time we use it on massive trauma patients and it
has
even been used on coumadin induced bleeding.
It is very expensive. One small vial costs about $ 1200 if I remember
correctly.
The advantage in massive traumas is that the need for more many blood
units
is reduced and thus save the blood supply.
I have personally called the doctor and advised him on many occasions
of
that option.
good for you Robert!!! are you an ER nurse???
No I protect the blood supply in the blood bank and all Novoseven is
issued
by us. I am licensed as a clinical laboratory scientist. National
registration MT(ACSP).
|
ahhh....forgot the intitials !!
| Quote: | actually the stats on strokes say 90% are clots...so introducing a
clotting
agent is NOT a smart idea!! esp since the thrombolytics need to be given
within hours of onset....
As you state it is contra indicated in thrombotic conditions including
DIC.
It is a rapid reversal in comparison to fresh frozen plasma. You need an
acute diagnosis obviously before it should be given.
I surely can see the use of anti clotting agents in the situations you
describe....continue to keep the docs up to date!!!
Like anything out there that is new it starts with one use and people
obtain
experience with it and then people start using it for other conditions.
FDA
approval is still limited in use although clinical studies have expanded
the
use.
It is used by trauma surgeons at our institution. Doctors in other
departments are urged to contact the trauma surgeons for their experience.
If you have 2 O neg units in the fridge and the patient has used already
used 10 or if the patient has used 20 units then it is time for some sort
of
intervention.
amazing how often "we nurses" read more journals,,etc than the docs...
I have some funny stories I have seen involving doctors that I would
rather
not mention here.......:-)
|
me too!!! |
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| Back to top |
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Robert
medicine forum Guru
Joined: 28 Apr 2005
Posts: 1700
|
| Posted: Fri Jun 10, 2005 12:43 am Post subject:
Re: clotting agent shows promise with worst strokes
|
|
|
<Hawki63@sbcglobal.net> wrote in message > >> good for you Robert!!! are
you an ER nurse???
| Quote: |
No I protect the blood supply in the blood bank and all Novoseven is
issued
by us. I am licensed as a clinical laboratory scientist. National
registration MT(ACSP).
ahhh....forgot the intitials !!
|
The MT is not massage therapist but Medical Technologist. Board certified
American Society of Clinical Pathology
Woops should be ASCP not ACSP ;-)
Some states have state licensure while other states accept the ASCP
registration. 4 year degree with clinical practice followed by board
examination.
Lab technicians are usually 2 year degree and examination.
MLT
| Quote: |
actually the stats on strokes say 90% are clots...so introducing a
clotting
agent is NOT a smart idea!! esp since the thrombolytics need to be
given
within hours of onset....
As you state it is contra indicated in thrombotic conditions including
DIC.
It is a rapid reversal in comparison to fresh frozen plasma. You need an
acute diagnosis obviously before it should be given.
I surely can see the use of anti clotting agents in the situations you
describe....continue to keep the docs up to date!!!
Like anything out there that is new it starts with one use and people
obtain
experience with it and then people start using it for other conditions.
FDA
approval is still limited in use although clinical studies have expanded
the
use.
It is used by trauma surgeons at our institution. Doctors in other
departments are urged to contact the trauma surgeons for their
experience.
If you have 2 O neg units in the fridge and the patient has used already
used 10 or if the patient has used 20 units then it is time for some
sort
of
intervention.
amazing how often "we nurses" read more journals,,etc than the docs...
I have some funny stories I have seen involving doctors that I would
rather
not mention here.......:-)
me too!!!
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