Warfarin Bleeding Managmeent

Question 1

What is the first step in managing major bleeding like variceal or intracranial haemorrhage?

Answer 1

Stop warfarin

Major bleeding management includes stopping anticoagulation to prevent further complications.

Question 2

What is the recommended dose of intravenous vitamin K for major bleeding management?

Answer 2

5mg

Vitamin K is administered to help reverse the effects of warfarin.

Question 3

What is the alternative to prothrombin complex concentrate in major bleeding if it is not available?

Answer 3

FFP

Fresh frozen plasma can be used to provide clotting factors when prothrombin complex concentrate is unavailable.

Question 4

What should be done if INR is over 8 with minor bleeding?

Answer 4

• Stop warfarin
• Give intravenous vitamin K 1-3mg
• Repeat dose of vitamin K if INR still too high after 24 hours
• Restart warfarin when INR < 5.0

Managing high INR in minor bleeding involves careful monitoring and adjustment of anticoagulation therapy.

Question 5

What steps should be taken if INR is over 8 with no bleeding?

Answer 5

• Stop warfarin
• Give vitamin K 1-5mg by mouth
• Repeat dose of vitamin K if INR still too high after 24 hours
• Restart when INR < 5.0

Oral administration of vitamin K is recommended for patients with high INR and no active bleeding.

Question 6

What is the management protocol for INR between 5-8 with only minor bleeding?

Answer 6

• Stop warfarin
• Give intravenous vitamin K 1-3mg
• Restart when INR < 5.0

This protocol helps to stabilize patients while minimizing the risk of thrombosis.

Question 7

What should be done if INR is between 5 to 8 with no bleeding?

Answer 7

• Withhold 1 or 2 doses of warfarin
• Reduce subsequent maintenance dose

Adjusting the warfarin regimen is essential to prevent potential bleeding complications.

Question 8

When do oh ou give prothrombin complex concentrate?

Answer 8

Only in major bleeds