Urgent Surgery & Anticoagulation (1*)

Question 1

When does warfarin have to be stopped?

What should pts with high risk of bleeding be given?

What should be done if the surgery is an emergency?

Answer 1

➊ 5 days before elective surgery
• Oral Vit K should be given the day before surgery if INR 5+

➋ Bridging (interim therapy) with a LMWH

➌ • If it can be delayed for 6–12 hrs - give IV Vit K
• If it can’t be delayed - give Prothrombin complex precipitate and IV Vit K