Utilization of alteplase in trauma victim with an open abdomen

Trauma victims with multisystem injuries are at risk for the development of deep vein thrombosis and pulmonary embolus (PE). The use of thrombolytic therapy remains very controversial and not well-documented in both the postsurgical and trauma subset of patients. Major trauma, surgery or head injury have been noted as absolute contraindications to thrombolysis in acute myocardial infarction. The decision to utilize thrombolytic therapy cannot be algorithmic; it must be based on the assessment findings for each individual patient. The risk to benefit ratio should be the major consideration to ensure the best possible outcome is granted. Treating injured patients experiencing high-risk PE causing an immediate threat to life may necessitate forming a comparative view of the adverse events associated with thrombolytic medications.