Help, I Cannot Stop the Bleeding!
A 78-year-old man is brought to the emergency department (ED) after falling on ice and sustaining head trauma outside of his home. A computed tomography (CT) head scan shows intracranial hemorrhage (ICH). The patient is noted to have a medical history significant for nonvalvular atrial fibrillation for which he takes rivaroxaban anticoagulant medication 20 mg orally once daily. The patient is reported to weigh 65 kg. Coagulation laboratory studies show prothrombin time (PT) 17.2 s and activated partial thromboplastin time (aPTT) 30.0 s. A type and screen (ethylenediaminetetraacetic acid [EDTA] anticoagulant) is submitted to the blood bank along with a stat request for four units of fresh frozen plasma (FFP).
KeywordsApixaban Bebulin Dabigatran Edoxaban Idarucizumab International normalized ratio/INR Kcentra Novel anticoagulants/NOAC Profilnine Prothrombin complex concentrate/PCC Rivaroxaban Warfarin
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