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Case: 72yo Female on Factor Xa Inhibitor with ICH

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Advanced Management of Life-Threatening Bleeding in the Anticoagulated Patient

Case: 72yo Female on Factor Xa Inhibitor with ICH

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  • Overview

    This program discusses the role of reversal agents in the presence of life-threatening bleeds while on an anticoagulant. It focuses on managing the anticoagulated patient with life-threatening intracranial bleeding, gastrointestinal bleeding, and post-traumatic bleeding in the Emergency Department. This enduring activity was originally presented as a satellite symposium which was held during the ACEP 2022 Scientific Assembly in San Francisco, CA. 

  • Target Audience

    This program is designed to meet the educational needs of physicians involved in the management of patients with life-threatening bleeds in the presence of an anticoagulant.

  • Learning Objectives

    After participating in this educational activity, participants should be better able to:

    • Discuss the risk factors for DOAC-related bleeding, as well as the appropriate diagnosis and monitoring of a life-threatening bleed, along with the associated need for treatment with a reversal strategy, particularly for ICH
    • Identify the appropriate diagnostic approaches to upper and lower GI bleeding, describe the essential treatment and specialist interventions, and implement treatment
    • Review the clinical applications and recommendations associated with repletion and reversal agents for DOACs, based on an understanding of the mechanism of action, benefits, risks, dosing, monitoring, and management of these agents including anti-vitamin K therapies such as coumadin, or specific direct treatments such as Factor Xa or Factor IIa anticoagulants, and describe their application to clinical practice in the management of life-threatening bleeding
  • Accreditation Statement

    Joint Accreditation Statement
    This activity has been planned and implemented in accordance with the accreditation requirements and policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint providership of the University of Cincinnati Office of Continuing Medical Education, EMCREG-International and TotalCME, Inc. The University of Cincinnati is accredited by the ACCME to provide continuing medical education for physicians.

    The University of Cincinnati designates this online activity for a maximum of 1.0 AMA PRA Category 1 Credit™. Physicians should claim only the credits commensurate with the extent of their participation in the activity.

  • Disclosure Statement

    Off-Label Disclosure Statement
    Faculty members are required to inform the audience when they are discussing off-label, unapproved uses of devices and drugs.  Physicians should consult full prescribing information before using any product mentioned during this educational activity.

    Learner Assurance Statement
    The University of Cincinnati is committed to resolving all conflicts of interest issues that could arise as a result of prospective faculty members’ significant relationships with drug or device manufacturer(s).  The University of Cincinnati is committed to retaining only those speakers with financial interests that can be reconciled with the goals and educational integrity of the CME activity. 

  • Faculty Disclosure of Commercial Relationships

    In accordance with the ACCME Standards for Commercial Support of CME, the speakers for this course have been asked to disclose to participants the existence of any financial interest and/or relationship(s) (e.g., paid speaker, employee, paid consultant on a board and/or committee for a commercial company) that would potentially affect the objectivity of his/her presentation or whose products or services may be mentioned during their presentation.

    The following disclosures were made:

    Brooks D. Cash, MD, faculty for this educational event, is a consultant for AstraZeneca.
    W. Brian Gibler, MD, faculty for this educational event, is a board member, advisor, and shareholder for Entegrion; board member and shareholder for EMCREG-International.
    Natalie Kreitzer, MD, MS, faculty for this educational event, is a speakers bureau member for Alexion.
    Babak Sarani, MD, faculty for this educational event, is a review panel member for Portola Pharmaceuticals.

    All the relevant financial relationships for these individuals have been mitigated. 

  • Planners and Managers Disclosure List

    The following planners/reviewers/managers have disclosed:

    W. Brian Gibler, MD, planner for this educational event, is a board member, advisor, and shareholder for Entegrion; board member and shareholder for EMCREG-International.
    Bruce Gebhardt, MD, University of Cincinnati reviewer for this educational event, has no relevant relationships with ineligible companies.
    Susan P. Tyler, planner for this educational event, has no relevant financial relationships with ineligible companies. 
    Barbara Forney, planner for this educational event, has no relevant financial relationships with ineligible companies. 

    TotalCME, Inc. planners and managers have no relevant commercial relationships to disclose.

    All the relevant financial relationships for these individuals have been mitigated. 

  • Disclaimer

    The opinions expressed during the live activity are those of the faculty and do not necessarily represent the views of the University of Cincinnati. The information is presented for the purpose of advancing the attendees’ professional development. 

  • Acknowledgement

    This activity is supported by an independent educational grant from AstraZeneca.

    Jointly provided by University of Cincinnati College of Medicine Office of Continuing Medical Education, EMCREG-International, and TotalCME, Inc.

  • Fee Statement

    This activity is FREE to all participants.

  • Instructions for Completion

    During the period 10/17/2022 through 10/17/2023, registered participants wishing to receive continuing education credit for this activity must follow these steps:

    • Read the learning objectives and faculty disclosures.
    • Answer a pre-program question.
    • View the program.
    • Complete the post-test with a score of 100%. 
    • Complete activity evaluation.
    • Apply for credit and either bank your credits or print your certificate.
  • System Requirements

    Our site requires a computer, tablet, or mobile device and a connection to the Internet. For best results, a high-speed Internet connection is recommended (DSL/Cable/Fibre). We also recommend using the latest version of your favorite browser to ensure compliance with W3C standards, such as Chrome, Safari, Firefox, or Microsoft Edge.

  • Publication Dates

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    Expiration Date:

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Schedule8 Feb 2023