Whoa. Scary.
Well, that's one way of putting it....
whoa.....
As middle-aged bikers try to relive the excitement of youth, that messy episode will be happening more and more, and in an ED near you.
Those young at heart may not even wear their helmets so the air can rush through their [remaining] hair!
Our ER Docs call them Donorcycles.
OK, I'm just a simple country boy from Georgia, not a wise medical guy like y'all.
Plavix is to prevent strokes and heart attacks, right? Something about thinning out blot clots. But does it cause impairment?
Seeing your post I was thinking about Kennedy's drug of choice: Ambien.
My cervical discs are drying out and disintergrating. I'm not a candidate for surgery - yet - so I'm just on pain medicine. Percocet 10/325 every 6 hours. BUT I have to take GREAT CARE as not to take it within 2 hours of driving ANYWHERE: if I take it at 4 pm I won't leave work until after 6 pm, no excuses. There's something about dying and missing out on chili dogs and Coca-Cola such that I don't fool around with the high-powered stuff.
THANKS for a great visual. My gentle bride works for an Internal Medicine group and I'm printing your post out for her office.
Nicely done. A few pictures, several thousand words (and maybe tears?) saved.
Whoa! Point taken!
Man of few words, eh?
Yeah, that Plavix is bad stuff. At least you can give FFP and vitamin K to reverse Coumadin.
Got somethin' against unhealthy, aging Harley riders?
Impressive.
Any questions?
Yes. As someone who prescribes Plavix very often (most patients are post ACS/PCI/stent implanation) am wondering if I need to counsel against high trauma risk behavior while on Plavix?
Does giving platelets in patients on Plavix help reduce bleeding complications at all? (Given the amount of heme on the floor, doubt anything would have helped this pt, but in general...)
OK -- obviously, the blood on the floor photo isn't mine -- too busy taking care of patients to take such a photo, but it does mirror a recent case. PLAVIX IS A GREAT DRUG, especially for the patient who has recently had coronary artery stents placed. Unfortunately, it is also a drug that causes problems for trauma patients; as Dr. Parker states above, Coumadin can be reversed with vitamin K and FFP, but Plavix cannot.
So, if I were a physician/NP prescribing Plavix, I would cousel against certain activities --- motorcycle riding, skydiving, etc --- because there is no feasible method of reversing the effects of Plavix. Platelet transfusion is unhelpful, as the new platelets are rapidly affected by the drug, and there does not seem to be any "saturation" effect. I would also ensure that my patients were taken off the drug when the maximal potential benefit had passed.
The most problematic trauma patient on Plavix is the head injured patient; evacuating a subdural hematoma in such a patient is unfortunately an exercise in frustration and coagulopathy.
Uh... Tht pretty much sums it up allright. Scary enough hoppin on a bike anymore w/ road rage rampant.. mix w/ a little druggage and you're really in riskin it.
Yuck!
Flea
Thanks for the info. Will incorporate into my pt education.
Who needs words, I showed that one to my kids. I think you might have left out the plavix though and still ended up with the same result in many cases.
Mimi
Whoa. Got the message LOUD and CLEAR!
No questions. However, I must make sure that my Dad either never takes Plavix or gives up the GoldWing if he does. Thanks for the heads up.
I had a good laugh about that.
The last photo was deducible from the first one. People who ride cycles are at high risk when doing so. (My opinion, based on burying some friends who rode.)
Seems to be some confusion in the comments, however.
Mood-altering substances and machinery are a bad combination, but that's not the point.
Plavix seems to be an anticoagulent of some sort. The point seems to be that injuries which might otherwise be survivable might result in bleed-out if sustained while on Plavix.
Anyhow, stay safe. If you must ride, make sure your last wishes are known.
Mike
I was wondering, does it change anything if the patient is on aspirin instead of Plavix? (I figure the guys on ASA+Plavix are dead meat from the start.)
As far as reversing it is concerned, there's always NovoSeven, isn't there?
Actually, NovoSeven does not help in this situation; it has been tried, but is not even recommended by the package insert. Platelet transfusions would seem to be the best bet, but they are almost immediately affected by the effect of the drug. ASA and Plavix are sometimes used in combination, but I would love to see some convincing study as to why. Plavix is a great drug, but needs to be utilized appropriately, IMHO.
If aspirin provides a 23% Risk Reduction and plavix raises it to around 31%, why bother to add Plavix?
Commenting by HaloScan
