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Rebellion in EM 2019: 3 Things That Have Changed the Way I Intubate

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martes, 27 de febrero de 2018

Reversing DOAC in intracraneal bleeding

An online community of practice for Canadian EM physicians
CanadiEM - By Andrew Shih - February 27, 2018
"Main Messages
  • When managing DOAC-associated bleeding, consider the interventions that you would perform if the patient was not on a DOAC. Tranexamic acid has an excellent safety profile based on RCTs. Definitive procedural intervention remains the cornerstone of therapy.
  • Specific reversal agents should be used whenever possible. PCCs and FEIBA are options in factor Xa inhibitor associated bleeding in the absence of a specific reversal agent, where thrombosis risk is low but should be discussed during consent.
  • Plasma and platelet transfusion should only occur when indicated as if the patient was not on a DOAC."