Warfarin Reversal Consensus Guidelines
* Bleeding risk increases exponentially from INR 5 to 9; INR >6 should be monitored closely
ˆ High risk bleeding factors include active gastrointestinal disorders, concomitant anti-platelet therapy, major surgical procedure within preceding 2 weeks, thrombocytopenia

In severe bleeding, prothrombinex is preferable to FFP as it is usually more immediately available

ALWAYS SEEK EXPERT HAEMATOLOGY ADVICE IF UNSURE

Oral Anticoagulation During Invasive Procedures
* Exercise caution in patients with impaired renal function (creatinine clearance rate <30ml/hour). LMWH can accumulate & contribute to bleeding.

NOTE: Patients with prosthetic valves & those who have had an acute thrombosis within the preceding three months should receive bridging anticoagulation peri- & post-operatively.

ALWAYS SEEK EXPERT HAEMATOLOGY ADVICE IF UNSURE