Trauma and oral anticoagulants

Patients on oral anticoagulants who present to the emergency department following trauma pose a special problem. Careful attention must be given to exclude any sites of overt or occult bleeding, particularly in the CNS, where there may be no external evidence of injury. A PT or thrombotest should be obtained as minimum laboratory workup in all cases. In specific situations, emergency reversal of anticoagulation must be undertaken.