Trauma patients on new oral anticoagulation agents have lower mortality than those on warfarin. Maung AA, Bhattacharya B, Schuster KM, Davis KA.The Anticoagulated trauma patient in the age of the direct oral anticoagulants: a Canadian perspective. Wood B, Nascimento B, Rizoli S, Sholzberg M, McFarlan A, Phillips A, Ackery AD. ![]() **NOT indicated for TBI or ICH unless neurosurgical intervention planned Avoid if patient is going to the OR soon to avoid delaying operative interventions Consider NGT placement for administration. ![]() *When considering activated charcoal administration, assess the patient’s mental status and ability to protect their airway. (4) Multiple studies have demonstrated the superiority of PCC over FFP in quick reversal and achieving INR150 Recently, the introduction of prothrombin complex concentrates (PCC) have allowed for much quicker and reliable reversal of vitamin K antagonists. (1, 2, 5-7) This could be attributed to the long half-life of these drugs as well as the propensity to have supra-therapeutic levels due to non-standardized dosing.Ĭlassical strategies for warfarin reversal include administration of vitamin K and fresh frozen plasma (FFP). ![]() Interestingly, multiple studies have demonstrated that the worst outcomes were observed with patients on vitamin K antagonists (warfarin). (7, 12) It is important to recognize the impact of such agents on patient outcome and administer early reversal when clinically indicated to prevent further complications. Pre-injury anticoagulation has been shown to be an independent predictor of mortality. ![]() (1) Those patients are generally older with multiple medical comorbidities. The number of trauma patients on anticoagulant and antiplatelet therapy is increasing steadily, especially those on novel oral anticoagulants (NOACs). Purpose: To simplify the choice and dosing of reversal agents and strategies in the setting of traumatic bleeding in patients taking anticoagulants and antiplatelet therapy
0 Comments
Leave a Reply. |