A 68-year-old woman has been prescribed Rivaroxaban 20 mg daily for atrial fibrillation. She presents 6 months later with melaena and a haemoglobin of...

Question

A 68-year-old woman has been prescribed Rivaroxaban 20 mg daily for atrial fibrillation. She presents 6 months later with melaena and a haemoglobin of 72 g/L. She is haemodynamically unstable (HR 118, BP 88/52). She has no specific reversal agent available locally. What is the MOST appropriate immediate management?

Accepted Answer

Administer four-factor prothrombin complex concentrate (PCC) at 50 units/kg

Answer

Give Vitamin K 10 mg intravenously

Answer

Give Protamine sulphate

Answer

Administer tranexamic acid 1 g IV and supportive resuscitation only

Answer

Wait for Andexanet alfa to be transferred from another hospital

uk-dgm MCQ (SBA): DOAC Reversal in Major Haemorrhage