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Specialty: Emergency Medicine
Drug: Coumadin
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Total 39 results found since Jan 2013.
The effect of management models on thromboembolic and bleeding rates in anticoagulated patients: an ecological study
AbstractThe primary study objective is to compare the outcomes of patients taking oral anticoagulant medications in two distinct populations treated according to different management models (comprehensive vs. usual care). (Design: regional prospective cohort study; setting: hospital admission data from two regions). Eligible partecipants were patients taking oral anticoagulant drugs (vitamin K antagonist or direct oral anticoagulants), residents in the Vicenza and Cremona districts from February 1st, 2016 to June 30th, 2017. Patients were identified by accessing the administrative databases of patient drug prescripti...
Source: Internal and Emergency Medicine - July 14, 2019 Category: Emergency Medicine Source Type: research
The Yield of Computed Tomography of the Head Among Patients Presenting With Syncope: A Systematic Review.
CONCLUSION: More than half of patients with syncope underwent CT head with a diagnostic yield of 1.1% to 3.8%. A future large prospective study is needed to develop a robust risk tool.
PMID: 31006937 [PubMed - as supplied by publisher]
Source: Accident and Emergency Nursing - April 21, 2019 Category: Emergency Medicine Authors: Viau JA, Chaudry H, Hannigan A, Boutet M, Mukarram M, Thiruganasambandamoorthy V Tags: Acad Emerg Med Source Type: research
Throwing it in reverse: An update on reversal of oral factor Xa inhibitors
In recent years, the use of oral Factor Xa (FXa) inhibitors such as rivaroxaban and apixaban, have seen more extensive utilization for stroke prevention in non-valvular atrial fibrillation and the prevention/treatment of venous thromboembolisms [1,2]. Some studies have shown a similar bleed risk between FXa inhibitors and warfarin while other studies demonstrated a decreased risk for a bleed with FXa inhibitors. Despite a possible decreased risk, the paucity of data available for treating an acute major bleed due to FXa inhibitors has led some clinicians to shy away from their use.
Source: The American Journal of Emergency Medicine - April 7, 2019 Category: Emergency Medicine Authors: Brian W. Gilbert, Jacob A. Reeder, Mohammed A. Alkhalifah, David A. Moran, Michael A. Corvino Source Type: research
Accidental Rivaroxaban Intoxication in a Boy: Some Lessons in Managing New Oral Anticoagulants in Children
We report a child who presented abnormal coagulation tests after unintended ingestion of 4 tablets of rivaroxaban. The patient was treated with fresh frozen plasma as well as admitted to intensive care and improved several hours later. We discuss his presentation and review of the literature on this topic.
Source: Pediatric Emergency Care - March 1, 2019 Category: Emergency Medicine Tags: Illustrative Cases Source Type: research
Blood Pressure Management Goals in Stroke Care
Blood pressure management goals in stroke care
You arrive at a small rural emergency healthcare facility to transport a 72-year-old female who presents to the ED with the worst headache of her life. She’s to be transported to a tertiary center with neurosurgical services.
Upon further questioning you determine her headache was sudden onset with maximum intensity.
When reviewing her history and medications, you note that she’s currently on Coumadin (warfarin) with an international normalized ratio (INR) of 3.5, with the following vital signs noted on the monitor upon entering the room: blood pressure of 209/75 mmHg; hea...
Source: JEMS Patient Care - May 1, 2018 Category: Emergency Medicine Authors: Ken Davis, BA, EMT-P, FP-C Tags: Patient Care Cardiac & Resuscitation Source Type: news
Direct Oral Anticoagulant or Warfarin Related Major Bleeding
Recent years have marked the development of antithrombotic agents besides warfarin in the prevention of stroke in patients with atrial fibrillation. Initial studies have demonstrated equal or lower mortality following major bleeding related to Direct Oral Anticoagulants (DOACs) when compared with warfarin despite the lack of reversal agents early on. A major limitation of these studies was a low rate of warfarin reversal (
Source: The Journal of Emergency Medicine - November 1, 2017 Category: Emergency Medicine Authors: Tara Garland Tags: Abstract Source Type: research
Anticoagulation therapy among patients presenting to the emergency department with symptomatic atrial fibrillation – the FinFib2 study
Conclusion: These data showed that OAC was prescribed frequently to patients with symptomatic AF and risk factors for stroke. However, in patients using warfarin, international normalized ratio was not at the therapeutic level in a large proportion of the patients with previously diagnosed AF.
Source: European Journal of Emergency Medicine - August 30, 2017 Category: Emergency Medicine Tags: Original Articles Source Type: research
Management of Factor Xa inhibitor-associated life-threatening major hemorrhage: A retrospective multi-center analysis
This study describes a cohort of patients with FXa inhibitor-associated life-threatening bleeding events, their clinical characteristics, interventions and outcomes.
Source: The American Journal of Emergency Medicine - August 19, 2017 Category: Emergency Medicine Authors: Truman J. Milling, Carol L. Clark, Charles Feronti, Shlee S. Song, Sam S. Torbati, Gregory J. Fermann, Jeffrey Weiss, Dony Patel Source Type: research
Dabigatran etexilate: appropriate use in patients with chronic kidney disease and in the elderly patients
AbstractDabigatran etexilate (DE) is a direct thrombin inhibitor, which has been approved for the treatment of non-valvular atrial fibrillation (AF), and for the prevention and treatment of venous thromboembolism (VTE). Despite large randomized clinical trials and independent observational studies providing robust data concerning DE safety and efficacy, some physicians still perceive mild-to-moderate renal impairment and old age as a relative contraindication to its use. In this article, we review the available scientific evidence supporting the use of DE in these clinical situations. Patients with AF and chronic kidney di...
Source: Internal and Emergency Medicine - April 24, 2017 Category: Emergency Medicine Source Type: research
The role of delayed head CT in evaluation of elderly blunt head trauma victims taking antithrombotic therapy
ConclusionsD-CTH in elderly trauma patients taking antithrombotic agents shows no statistically significant or clinical benefit for diagnosing delayed intracranial hemorrhage after minor head injury. In those with delayed imaging showing new ICH, management was not significantly altered. Not enough data were available to predict which patients would develop D-ICH, even if asymptomatic.
Source: European Journal of Trauma and Emergency Surgery - April 24, 2017 Category: Emergency Medicine Source Type: research
Role of prothrombin complex concentrate (PCC) in Acute Intracerebral Hemorrhage with Positive CTA spot sign: An institutional experience at a regional and state designated stroke center
ConclusionsWe found a strong statistical correlation favoring our hypothesis. Use of PCC in active ICH with positive CTASS resulted in overall decrease in the mean hematoma size at 24 h, whereas the control group showed an overall increase.
Source: Emergency Radiology - December 2, 2016 Category: Emergency Medicine Source Type: research
Direct oral anticoagulants: a practical guide for the emergency physician
The direct oral anticoagulants (DOACs) are the mainstay for stroke prophylaxis in nonvalvular atrial fibrillation and treatment of acute venous thrombosis. They are attractive alternatives to warfarin because of their efficacy, ease of prescription and safety profile. The emergency department has gained expertise in the management of DOAC bleeding complications, but has been slower to adopt prescription decisions. Emergency clinicians are in a unique position to identify patients who are prescribed DOACs and are at high risk of impending bleeding. This is a practical guide for the emergency clinician on how to prescribe DO...
Source: European Journal of Emergency Medicine - September 8, 2016 Category: Emergency Medicine Tags: Review Articles Source Type: research
The Severity of Bleeding and Mortality in Trauma Patients Taking Dabigatran
Dabigatran, a direct thrombin inhibitor, has been shown to be more effective than warfarin in the prevention of stroke in patients with atrial fibrillation. Until recently, it lacked a reversal agent, and its contribution to the risk of transfusion in injured patients is unknown.
Source: The Journal of Emergency Medicine - June 26, 2016 Category: Emergency Medicine Authors: Zachary D.W. Dezman, Angela C. Comer, Gordon S. Smith, Mayur Narayan, John R. Hess, Jon Mark Hirshon Tags: Brief Report Source Type: research
