I tried to create a heuristic approach to reversal of oral anticoagulant induced bleeding.
Four basic principles guide your approach:
- Identify the drug and it’s mechanism of action as either anti-platelet or anti-clotting cascade.
- Predict the time to hemostasis (or loss of anticoagulation effect) with no intervention (mechanism of action, metabolism, elimination, hepatic function, renal function, etc)
- Establish the time frame for the NEED for hemostasis
- 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