title: Retrospective review of Prothrombinex use by SAAS MedSTAR.
abstract: OBJECTIVE
  The aim of this study was to review and describe the use of Prothrombinex by a physician-led retrieval service based remote from a hospital blood bank.
  
  
  METHODS
  This is a retrospective observational study. Patients to whom Prothrombinex was administered by the retrieval team were identified from the retrieval service patient database. The paper case cards of the identified patients were then manually reviewed and the data matched to patients in the state-wide electronic laboratory record.
  
  
  RESULTS
  Between 1 January 2010 and 30 November 2013 38 cases were identified. For 28 the indication was warfarinisation associated with life-threatening bleeding (most commonly intracranial or gastrointestinal tract). In the remaining 10 cases, Prothrombinex was used to treat coagulopathy associated with liver disease or massive haemorrhage. The median time saved by the retrieval team administering PTX-VF, rather than waiting to the receiving centre, was 120 min (interquartile range: 85-195 min). The median dose of PTX-VF administered was 23.25 IU/kg (interquartile range: 20-33 IU/kg). Paired international normalised ratios (INRs) were available for 33 of the 38 patients. In the warfarin group, all patients had an improvement in their INR and 21 of 25 had correction of their INR. In the non-warfarin group, the effect on INR was more variable.
  
  
  CONCLUSIONS
  Prothrombinex is a clinically useful product that can be relatively easily stored and used by retrieval services, even if they are based in isolation from a hospital blood bank. More research is required to look at the utility of Prothrombinex for non-warfarin-related bleeding in the pre-hospital and retrieval environment.
authors.affiliation: MedSTAR Emergency Medical Retrieval, SA Ambulance Service (SAAS), Adelaide, South Australia, Australia.
authors.forename: Roy
authors.initials: R
authors.lastname: Fischer
authors.affiliation: MedSTAR Emergency Medical Retrieval, SA Ambulance Service (SAAS), Adelaide, South Australia, Australia.
authors.forename: Simon
authors.initials: S
authors.lastname: Brettig
authors.affiliation: MedSTAR Emergency Medical Retrieval, SA Ambulance Service (SAAS), Adelaide, South Australia, Australia.
authors.forename: Andrew
authors.initials: A
authors.lastname: Pearce
mesh_terms: D000328:Adult; D000368:Aged; D000925:Anticoagulants / Q000008:administration & dosage / Q000627:therapeutic use; D001771:Blood Banks / Q000458:organization & administration / Q000706:statistics & numerical data; D001778:Blood Coagulation Disorders / Q000150:complications / Q000188:drug therapy; D001779:Blood Coagulation Factors / Q000008:administration & dosage / Q000627:therapeutic use*; D004636:Emergency Service, Hospital / Q000458:organization & administration / Q000706:statistics & numerical data*; D005260:Female; D006471:Gastrointestinal Hemorrhage / Q000150:complications / Q000188:drug therapy; D006470:Hemorrhage / Q000188:drug therapy*; D006801:Humans; D020300:Intracranial Hemorrhages / Q000150:complications / Q000188:drug therapy; D008107:Liver Diseases / Q000150:complications / Q000188:drug therapy; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D018709:Statistics, Nonparametric; D061665:Time-to-Treatment / Q000706:statistics & numerical data*; D014859:Warfarin / Q000009:adverse effects
chemical_list: D000925:Anticoagulants; D001779:Blood Coagulation Factors; C025667:prothrombin complex concentrates; D014859:Warfarin
keywords: emergency care; pre-hospital; prothrombin complex concentrate; retrieval medicine