You are managing a 78-year-old female who has had a mechanical fall at home. She has pain in her right hip and the right leg appears shortened and ext...

Question

You are managing a 78-year-old female who has had a mechanical fall at home. She has pain in her right hip and the right leg appears shortened and externally rotated. She is on regular rivaroxaban for atrial fibrillation. While the fractured neck of femur is not immediately life-threatening, what specific anticoagulant-related concern must be communicated during handover?

Accepted Answer

Rivaroxaban affects the timing of surgical fixation - surgery may need to be delayed until drug levels fall or a reversal agent (andexanet alfa) is considered; communicate the last dose timing

Answer

The patient should receive FFP before transfer

Answer

Rivaroxaban should be reversed pre-hospital with vitamin K

Answer

Rivaroxaban means the patient cannot have any analgesia

Answer

Rivaroxaban has no effect on surgical planning

uk-dipimc MCQ (SBA): DOAC and Hip Fracture Surgery