Chris Baugh: Stabilize Measure Decide Managing Residual FXa Inhibitor Effects in Urgent Care
Chris Baugh, Chair Elect at Emergency Medicine Foundation, shared a post on LinkedIn:
“I recently joined Deborah Siegal (The Ottawa Hospital) for the second installment of this educational series on managing residual effects of oral direct FXa inhibitors in urgent clinical situations, moderated by Alex C Spyropoulos (Feinstein Institutes, Northwell Health).
This module, ‘Stabilize. Measure. Decide,’ tackles the question every acute care clinician faces when a patient on apixaban, rivaroxaban, or edoxaban presents with major bleeding or needs an urgent procedure: how much anticoagulant activity is actually still on board?
We walk through:
- Why routine coagulation assays (PT/INR, aPTT) fall short for FXa inhibitors, and where drug-specific anti-Xa testing fits
- A practical decision-making pathway for major bleeding vs. urgent surgery/procedures
- Emerging point-of-care options on the horizon, including urine dipstick and clot-based assays
The core message: stabilization comes first, testing should inform rather than delay care, and urgent decisions often have to be made without perfect information.
Thank you to Dr. Siegal for the excellent clinical dialogue, to Dr. Spyropoulos for moderating, and to Vasculearn Network and VarmX for making this series possible.”
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