In case you didn’t know or were wondering, using TPA in the trauma patient isn’t a good idea. It’s especially bad when the path of the bullet went across to top of the liver. And before you ask, yes there was a vascular injury and yes a vascular surgeon used the TPA.
I guess another way to say it is, “Why you should open the patient’s abdomen 3 different times before they leave the OR.”
Bottom line: Factor VII is great stuff and we closed the abdomen for the final time about 36 hours later.
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