Podcast #35: Coumadin Reversal - The Emergency Medical Minute

Podcast #35: Coumadin Reversal

dpt01721Run Time: 3 minute

Author: Dr. Samuel Killian

Educational Pearls:

  • 5 million people are on Coumadin. Coumadin is in the top 5 of most adverse events.
  • 2 options for reversal in the ER: Vitamin K and FFP or vitamin K and 4 factor PCC.
  • FFP is cheap but harder to use and takes longer – 18-20 hours. Also there are several complications such as: AVO compatibility, volume of medication, and transfusion injuries.
  • PCC is expensive, easier to use, and takes less time – 15 minutes. PCC has less adverse effects and reactions.
  • Study showed that 14 patients given FFP had complications (7%), and 14 patients given PCC had complications – mortality rate was the same.
  • PCC has rapidly become preferred method for reversing Coumadin coagulopathy for sick patients – head bleeds, gi bleeding, etc.

References:  http://www.annemergmed.com/article/S0196-0644(15)00387-X/fulltext


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