Stop transfusion
Observation alone may be appropriate in less severe cases
Protamine
Only indicated for major bleeding (0.2% of patients develop severe anaphylaxis)
Give 1mg IV for every 100 units of UFH infused in the prior 3hr
Give slowly over 1-3min; do not exceed 50mg in any 10 minute period
Because half-life is short (7 min) may require second treatment
Massive bleed
Cryoprecipitate (10 U IV), then FFP (& platelets, aminocaproic acid infusion if nec)
Only indicated for major bleeding (0.2% of patients develop severe anaphylaxis)
Give 1mg IV for every 100 units of UFH infused in the prior 3hr
Give slowly over 1-3min; do not exceed 50mg in any 10 minute period
Because half-life is short (7 min) may require second treatment
Cryoprecipitate (10 U IV), then FFP (& platelets, aminocaproic acid infusion if nec)
Unfractionated heparin reversal
Rivaroxaban reversal
Dabigatran reversal
Warfarin reversal
Anti-platelet agent reversal
Low molecular weight heparin
Prothrombin complex concentrates
Dalteparin