Clinical QuickieHematology/Coagulation
Anticoagulation + Bleeding
Identify the agent first. Reversal is drug-specific.
Name the anticoagulant
Warfarin, factor Xa inhibitors, dabigatran and heparins have different half-lives, laboratory effects and reversal strategies.
Severity determines urgency
Minor nuisance bleeding is not managed like intracranial, GI, retroperitoneal or hemodynamically significant bleeding.
Timing and organ function matter
Last dose, renal/hepatic function, interacting medications and indication for anticoagulation change both bleeding risk and how long effect persists.
Do not reverse reflexively
Reversal decisions balance bleeding severity against thrombotic risk and the expected persistence of the anticoagulant.
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