Reversal of oral anticoagulant induced bleeding

I tried to create a heuristic approach to reversal of oral anticoagulant induced bleeding.

Four basic principles guide your approach:

  1. Identify the drug and it’s mechanism of action as either anti-platelet or anti-clotting cascade.
  2. Predict the time to hemostasis (or loss of anticoagulation effect) with  no intervention (mechanism of action, metabolism, elimination, hepatic function, renal function, etc)
  3. Establish the time frame for the NEED for hemostasis
  4. Decide to intervene or not and pick an intervention typically combining a) antidotes, b) factor replacement, c) platelet transfusion, or d) procoagulants… depending.

Here it is:

Reversing Anticoagulant Induced Bleeding



The Hot Stove League of EM/Tox

In baseball, the hot stove league is a term used to describe a bunch of guys sitting around a hot stove in the winter time talking about all the moves their favorite baseball teams should make in the offseason. Well, I think #FOAMed is the hot stove league of medicine. When I reflect on the great learning moments of my medical career, I realize they often occurred when I was sitting around, chewing the fat with my favorite educators. When we were in the midst of patient care we generally focused on executing the game plan. Sitting around the ED and talking about what to do if… was the best way to get ready for a real emergency. This blog/cast is the hot stove where I sit down and teach Emergency Medicine and Medical Toxicology. Hope you like it!