Anticoagulant Reversal Drugs Stop Patient's Internal Hemorrhage

Pharmacology to the tune of anticoagulant reversal Your EMS flight crew is dispatched by rotor to a remote hospital in the Great Basin Desert for a patient with gastrointestinal (GI) bleeding. The patient was brought in by her grandson. She was vomiting blood as well as suffering from bloody diarrhea. On arrival, you find an 80-year-old female sitting up in a hospital bed, although she's extremely weak. She has a Glasgow coma scale (GCS) of 15 and states she's been throwing up blood all day. She appears pale but is in no obvious distress. Her vital signs are a heart rate of 100 with regular pulse; blood pressure 60/35 mmHg; respiratory rate of 20; and SpO2 of 94% with poor waveform on 2 L/min via nasal cannula. The patient's history is limited to atrial fibrillation and hypertension. Her nurse informs you that she's received 80mg Protonix (pantoprazole) and a liter of normal saline (NS). Given the patient's active GI bleed, her current blood pressure, and the 1.5 hour-plus flight to the receiving facility, you decide it's appropriate to request the hospital's only two units of packed red blood cells (PRBCs). You load the patient into the helo without difficulty. As you begin transport, you find yourselves facing a strong headwind. Your pilot says that because of this you'll have to stop for fuel on the way to complete transport. You and the crew put your heads together and decide the best course of action is to set down at your home hospital pad. This will take you off course...
Source: JEMS Patient Care - Category: Emergency Medicine Authors: Tags: Patient Care Columns Source Type: news