Well scan if a haemorrhage then consider beriplex to reverse the
anticoagulant quickly followed with vit K if infarct.....depends on thee
reason for anticoagulation possibly
Andy Webster
-----Original Message-----
From: Accident and Emergency Academic List
[mailto:[log in to unmask]] On Behalf Of [log in to unmask]
Sent: 11 December 2002 15:39
To: [log in to unmask]
Subject: Re: Warfarin & CVA
I would've thought he looked more like an infarct with that presentation
Peter, especially with his past history of TIA. I certainly wouldn't
have touched his warfarin. Sure, with the benefit of hindsight, assuming
that he did indeed have a brainstem bleed, then reversing his warfarin
might have prevented it from progressing. But that's not how medicine
works. In 9 out of 10 cases, reversing the warfarin would have caused an
extension of the infarct! The SHO (and patient) was just unlucky, that's
all...
Adrian Fogarty
> from: [log in to unmask]
> date: Wed, 11 Dec 2002 11:32:16
> to: [log in to unmask]
> subject: Re: Warfarin & CVA
>
> This may be old news but.....
> Had a 71 yr old chap in with dysarthria and facial weakness no
apparent
> limb weakness. On warfarin for IHD. previous TIA. Sitting
communicating
> with thumbs up and down with all whilst waiting cheerfully (!)for a
MAU.
> Sudden collapse. virtaul respiratory arrest, pinpoint pupils , bilat
> upgoing plantars.... (probably high temperature for those academics
out
> there) so pontine bleed seemed likely.
> SHO felt dreadful.... 'Should I have given him VitK?' she said 'Would
that
> have made a difference?' she said
> I said 'ermmmmm......... I am sure it wont have done........'
> So Q1 Any evidence for reversing warfarinisation in cva?
> what do we think?
> Cheers
> Peter Cutting
> SpR In Staying Up All Night
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