Management of hemorrhage complicated by novel oral anticoagulants in the emergency department: case report from the northwestern emergency medicine residency

Am J Ther. 2013 May-Jun;20(3):300-6. doi: 10.1097/MJT.0b013e3182878d18.

Abstract

Anticoagulation has long complicated the care of hemorrhage in the emergency department and other acute care settings. With the advent of novel anticoagulants such as direct thrombin inhibitors and direct factor Xa inhibitors, the absence of any direct antidote for these medications presents new and difficult challenges in the management of hemorrhagic complications in these patients. We present 2 cases of patients with hemorrhagic complications taking novel oral anticoagulants, their management, and outcomes.

Publication types

  • Case Reports
  • Clinical Conference

MeSH terms

  • Aged
  • Aged, 80 and over
  • Aneurysm, Ruptured / complications
  • Aneurysm, Ruptured / diagnosis
  • Aneurysm, Ruptured / therapy
  • Anticoagulants / adverse effects*
  • Anticoagulants / therapeutic use
  • Benzimidazoles / adverse effects*
  • Benzimidazoles / therapeutic use
  • Blood Coagulation Factors / therapeutic use*
  • Combined Modality Therapy
  • Dabigatran
  • Emergency Service, Hospital
  • Hemoperitoneum / diagnosis
  • Hemoperitoneum / drug therapy*
  • Hemoperitoneum / etiology
  • Hemoperitoneum / therapy
  • Hemostatic Techniques*
  • Humans
  • Iliac Aneurysm / complications
  • Iliac Aneurysm / diagnosis
  • Iliac Aneurysm / therapy
  • Male
  • Morpholines / adverse effects*
  • Morpholines / therapeutic use
  • Rivaroxaban
  • Subarachnoid Hemorrhage / diagnosis
  • Subarachnoid Hemorrhage / drug therapy*
  • Subarachnoid Hemorrhage / therapy
  • Thiophenes / adverse effects*
  • Thiophenes / therapeutic use
  • Thromboembolism / prevention & control
  • beta-Alanine / adverse effects
  • beta-Alanine / analogs & derivatives*
  • beta-Alanine / therapeutic use

Substances

  • Anticoagulants
  • Benzimidazoles
  • Blood Coagulation Factors
  • Morpholines
  • Thiophenes
  • beta-Alanine
  • Rivaroxaban
  • anti-inhibitor coagulant complex
  • Dabigatran