Management of severe bleeding in patients taking oral anticoagulants is complicated. Acute care physicians must be knowledgeable about the individual oral anticoagulant agents, the general management of anticoagulant-associated bleeding, and the strategies for effective use of factor repletion and specific reversal agents. With any oral anticoagulant, minor or “nuisance” bleeding is most common and can be managed without repletion or reversal. For major oral anticoagulant-associated bleeding, class-specific approaches should be used and the necessary treatment agents made readily available in the Emergency Department (ED), the Intensive Care Unit (ICU), and the surgical suite. Because the reversal agents for warfarin, the thrombin inhibitor dabigatran and the Factor Xa inhibitors apixaban and rivaroxaban are expensive and, like all therapies, have the potential for causing their own adverse events, acute care physicians must be sufficiently informed as to the risks and benefits before using these important new therapies.Read More
These expert specialists will describe the implications of managing hyperkalemia in their field with patients in the Emergency Department, Critical Care Units, and the Cardiology Clinic. Finally, an EMCREG-International Hyperkalemia Consensus Panel algorithm for the approach to management of patients with life-threatening hyperkalemia.
is provided for the clinician and can be expanded in size for use in a treatment area such as the Emergency Department or Critical
Care Unit.Read More
For emergency physicians, critical care physicians, hospitalists, cardiologists, internists, surgeons, and family physicians, the current approach and disease indications for treatment with anticoagulants such as coumadin, Factor IIa, and Factor Xa inhibitors are particularly relevant. When a patient treated with anticoagulants presents to the Emergency Department, Intensive Care Unit, or Operating Room with severe, uncontrollable bleeding, achieving rapid, controlled hemostasis is critically important to saving the patient’s life.Read More