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Anticoagulation Reversal

Core EM

Published 2019 Jun 6. Background Around 6 million people in the U.S. 2017 ACC Expert Consensus Decision Pathway on Management of Bleeding in Patients on Oral Anticoagulants: A Report of the American College of Cardiology Task Force on Expert Consensus Decision Pathways. Background Around 6 million people in the U.S. Clin Med (Lond).

FFP 130
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REBEL Cast Ep 118: The PROCOAG Trial – 4F-PCC for Trauma Patients?

REBEL EM

Reversal of Trauma-Induced Coagulopathy Using First-Line Coagulation Factor Concentrates or Fresh Frozen Plasma (RETIC): A Single-Centre Parallel-Group, Open-Label Randomised Trial. J Trauma Acute Care Surg 2019. Severe acute traumatic coagulopathy = PT >1.5 to 3.33; P = 0.72 to 2.10; P = 0.03 Lancet Haematol 2017.

FFP 145
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Best Practices for Upper Gastrointestinal Hemorrhage

ACEP Now

Fresh frozen plasma, or FFP, should only be given to cirrhotic patients as part of the massive transfusion protocol in cases of profound hypotension, as “patients with cirrhosis rarely have true enzymatic hypocoagulability, and FFP may worsen bleeding due to over-resuscitation and dilution of coagulation factors.”

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ToxCard: Iron

EMDocs

Coagulopathy: Parenteral vitamin K and/or fresh frozen plasma (FFP) as clinically indicated. McGraw Hill; 2019. Can titrate up to maximum of 40 mg/kg/hr, although hypotension may limit dose of deferoxamine. 10 Maximum daily dose of 6-8g total of defuroxamine. Blood transfusion for clinically significant blood loss.

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