Identifying Anticoagulated Patients in the ED and ICU - Who Should Receive Repletion or Reversal Therapy for Life-Threatening GI Bleeding?

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As the utilization of direct oral anticoagulants (DOACs) increases, there is a parallel increase in major bleeding events, especially intracranial hemorrhages, requiring hospitalization. Clinicians are not recognizing or distinguishing major from minor bleeding or appropriately employing emergent options to manage major bleeding. Recent solutions for DOAC related life-threatening bleeding are under-recognized and under-utilized solutions for patients with these life-threatening emergencies. Over the last 12-18 months, nationally recognized guidelines have provided clear direction on how best to manage these types of major bleeding events. As data emerges regarding new approaches to therapy, clinicians need to be aware of these new and effective approaches and to assess the benefits and risks associated with each of these approaches. Education provided by experts from the EMCREG-International network within this program correctly and promptly address patient treatment approaches to the appropriate healthcare professionals.

This program covers the optimal management of gastrointestinal bleeding in the anticoagulated patient, highlighting key considerations on when to use repletion or reversal therapy when these patients present to the ED or ICU.

Gastrointestinal Bleeding: When Is a Reversal Agent Indicated?
Brooks D. Cash, MD, FACP, AGAF, FACG, FASGE
Dan and Lillie Sterling Professor of Medicine
Chief, Gastroenterology, Hepatology, and Nutrition
University of Texas Health Science Center at Houston
Houston, TX

Optimal Management of the Anticoagulated Patient Having Severe GI Bleeding in the ED or ICU
William A. Knight IV, MD, FACEP, FNCS
Professor of Emergency Medicine, Neurology and Neurosurgery
University of Cincinnati
Cincinnati, OH

Case Study: A 78-Year-Old Female Vomiting Blood and Hypotensive,  Anticoagulated with DOAC
William A. Knight IV, MD, FACEP, FNCS
Professor of Emergency Medicine, Neurology and Neurosurgery
University of Cincinnati
Cincinnati, OH

PANEL DISCUSSION WITH W. BRIAN GIBLER, MD