Emerg Med J 30:316-319 doi:10.1136/emermed-2012-201334
  • Original article

The use of recombinant activated factor VII (rFVIIa) in the management of patients with major haemorrhage in military hospitals over the last 5 years

  1. J E Smith1,2
  1. 1Academic Department of Military Emergency Medicine, Royal Centre for Defence Medicine, Birmingham, UK
  2. 2Emergency Department, Derriford Hospital, Plymouth, UK
  1. Correspondence to Surg Cdr J E Smith RN, Senior Lecturer, Academic Department of Military Emergency Medicine, RCDM, Institute of Research and Development, Vincent Drive, Birmingham B15 2SQ, UK; jasonesmith{at}
  1. Contributors JES is the sole author of this manuscript.

  • Accepted 10 April 2012
  • Published Online First 19 May 2012


Introduction Recombinant activated factor VII (rFVIIa) has been used in the management of traumatic haemorrhage for a decade. Anecdotally, its use is decreasing. The aim of this study was to define the use of rFVIIa in UK deployed military hospitals over the last 5 years.

Methods A retrospective database review was performed, using the Joint Theatre Trauma Registry, for the period January 2006 to June 2011. Data collected included use of rFVIIa, injury severity score (ISS), survival and injury pattern. The temporal trend of rFVIIa use, taking into account the number of severely injured patients presenting during each time period, was then analysed.

Results During the period January 2006 to June 2011, 156 injured patients received rFVIIa. 146 of these (94%) had an ISS >15; there were 45 fatalities. The median ISS among the group receiving rFVIIa was 30, and 20 patients had an ISS in the range 60–75. There was a significant reduction in the use of rFVIIa in the second half of 2010 and the first half of 2011, compared with the previous 12-month period.

Conclusion The use of rFVIIa in UK deployed military hospitals has declined since 2010, which is likely due to a combination of factors, including a change in resuscitation practice in these units, and a change in emphasis of manufacturer's guidance.


  • Competing interests None.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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Among patients with minor TBI (GCS 13-15) getting CT scans ≥ 24 hours after injury, what proportion have a traumatic finding?


0.5% - 43% response rate
3% - 41% response rate
10% - 16% response rate

Related original article: PCT head imaging in patients with head injury who present after 24 h of injury: a retrospective cohort study

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