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Updated: Jan 2, 2026

Rapid Point-of-Care Assay of Enoxaparin Anticoagulant Efficacy in Whole Blood
Published on: October 12, 2012
Intraosseous administration of 4-factor prothrombin complex concentrate prior to emergent surgery after receiving
Patrick Ratliff1, Kaitlin Nutley1, William Schroeder1
1Department of Pharmacy Services, Saint Joseph Hospital, Lexington, KY, USA.
What Is Known And Objective:
The 4-factor prothrombin complex concentrate (4F-PCC) may be used to emergently achieve haemostasis in patients on anticoagulation prior to surgery. Limited data exist using the intraosseous route of administration of 4F-PCC in patients taking factor Xa inhibitors.
Case Description:
We describe a case of a 69-year-old female receiving oral apixaban that was successfully administered 4F-PCC using intraosseous access prior to emergent surgery to obtain haemostasis intraoperatively.
What Is New And Conclusion:
Intraosseous access may be a viable route of administration for 4F-PCC in patients receiving factor Xa inhibitors to achieve haemostasis when necessary.
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