A 70-year-old male on apixaban presents with melaena and haematemesis. His blood pressure is 85/50 mmHg and heart rate is 120 bpm. In the pre-hospital...

Question

A 70-year-old male on apixaban presents with melaena and haematemesis. His blood pressure is 85/50 mmHg and heart rate is 120 bpm. In the pre-hospital setting, what is the most important management priority?

Accepted Answer

Administration of vitamin K 10 mg IV to reverse the anticoagulant

Answer

Standard major haemorrhage management with IV access, fluid resuscitation targeting SBP 80-90 mmHg, and rapid transfer to hospital

Answer

Insertion of a nasogastric tube to decompress the stomach

Answer

Administration of prothrombin complex concentrate pre-hospital

Answer

Administration of idarucizumab (Praxbind) 5 g IV

uk-dipimc MCQ (SBA): DOAC-Related Haemorrhage

A 70-year-old male on apixaban presents with melaena and haematemesis. His blood pressure is 85/50 mmHg and heart rate is 120 bpm. In the pre-hospital setting, what is the most important management priority?