Anticoagulant / Anti-platelet Reversal

North of Scotland major trauma guidelines
NHS Grampian
  • An INR and an APTTr of ≤1 excludes the presence of significant levels of novel anticoagulants in most patients.
  • Patients on warfarin should have this reversed, unless the bleed is extremely small, and the pro-coagulation risk is high.
  • Novel anticoagulants should be reversed with their specified reversal agent:
  • Please also refer to Antithrombotic Guidelines within NHS Grampian intranet
  • Reversal should occur within one hour of decision to reverse.
  • Advanced age is not an absolute predictor of poor outcomes following trauma and should not be used as the sole criterion for denying or limiting care.

Patients on warfarin should be reversed unless the bleed is extremely small and the procoagulation risk is extremely high.