Is anyone going to change their utilization criteria or process to deal with the new anti-coagulants? They will cause the PT/INR, APTT, TT to be high (Fib to appear low) but this does not correlate well to their anticoagulant effect. Also, these drugs can't be reversed by giving FFP.

Now, rather than looking at FFP recipients first for a pre-transfusion INR/PT we would need to find out if they are on one of the new anticoagulants because even if their PT/INR is high, they won't really be a candidate for FFP.

Would appreciate any solutions to this anyone has come up with.

We have tried that but the MD's state they have to do something and giving FFP won't hurt them. Shows how well MD paid attention in coag class.

We have tried that but the MD's state they have to do something and giving FFP won't hurt them. Shows how well MD paid attention in coag class.

That's right--TRALI is no big deal.........

That's right--TRALI is no big deal.........

TRALI? Isn't that what you ride in San Francisco?:confused: Maybe you can have a TACO while you ride the TRALI.:cool:

Anyway, dabigatran is not reversible so really, transfusion medicine should not even be involved in overdose cases. From my understanding, Dialysis would be the best option.

Very nice that the docs haven't thought about the "no reversing agent" part before prescribing these meds. Plavix was always our least favorite drug in BB (at least we can dump in platelets for that), now I think it's Pradaxa.

When the patient comes into the ED as a trauma (or bleeding due to the anticoagulant) and they do the routine coag screen and the results are all high due to dabigatran or rivaroxaban, I think it will still be a blood bank problem. Our coag depts may have to change their dosing info on the coag test orders so they know whether the patient is on coumadin or dabigatran.