A 19-year-old man was riding a motorcycle, which collided with a delivery truck. He complains of severe abdominal pain and is tachycardiac. He tells you that he has a history of von Willebrand disease. The product you should order to help control improve this patient's clotting ability is:
4 units of whole blood.
A 6 pack of platelets.
Recombinant factor VIIa.
Packed red cells.
Patients with von Willebrand disease have normal platelet counts and morphology but have diminished function due to lack of circulating von Willebrand factor. The ideal choice for this patient to help improve platelet aggregation would be Factor VIII. The initial dose would be 20–30 IU/kg every 12 hours. Fresh frozen plasma can be used as well in extreme conditions as desmopressin.