Active bleeding

Ease of use 2-6°C storage. Multiple application devices (linear, spray tips, endoscopic, etc.), 20 min preparation time. Set-up time = 30 s-3 min. May wash away in presence of active bleeding. Requires trained personnel to operate equipment. Preparation time required to obtain plasma component. Room temperature storage. 5 min preparation time. Single syringe applicator per kit. Set-up time - 3 min. Effective at site of active bleeding. 

The LMWHs are contraindicated in patients witii a hypersensitivity to the drug, heparin, or pork products and inpatients with active bleeding or thrombocytopenia... 

Thrombolytic dru are contraindicated in patients with known hypersensitivity, active bleeding, history of stroke, aneurysm, and recent intracranial surgery. 

Glycoprotein lib/ NSTE ACS, class lla recommendation for Active bleeding... 

EGD Multiple superficial ulcerations in the duodenum largest ulcer measures 2 cm in diameter no active bleeding noted. 

Deep vein thrombosis prophylaxis is recommended for septic patients. Low-dose unfractionated heparin or low-molecular-weight heparin may be utilized. Graduated compression stockings or an intermittent compression device is recommended for patients with a contraindication to heparin products (thrombocytopenia, severe coagulopathy, active bleeding, or recent intracerebral hemorrhage).24... 

Platelet transfusions are used to prevent hemorrhage. Patients with uncomplicated thrombocytopenia can be transfused when the platelet count falls below 10,000/pL (10 x 109/L). Patients who are either highly febrile or actively bleeding may require transfusions at higher levels. Red blood cell transfusions generally are not necessary for a hemoglobin concentration greater than 8 g/dL (80 g/L, 4.96 mmol/L). 

A large-diameter multihole urethral catheter should be inserted to facilitate saline lavage and evacuation of blood clots. Surgical removal of blood clots under anesthesia may be required if saline lavage is ineffective. Active bleeding from isolated areas may be cauterized with an electrode or laser. In severe cases that are unresponsive to local or systemic pharmacologic intervention,... 

The benefit and necessity of adding heparin to PN are unclear. There are also concerns about the stability/compatibility of intravenous lipid emulsions with heparin added at concentrations above 1 unit/mL. Heparin should be omitted in patients with active bleeding, thrombocytopenia, heparin-induced thrombocytopenia (HIT), or heparin allergy. 

Contraindications to heparin therapy include hypersensitivity to the drug, active bleeding, hemophilia, severe liver disease with elevated prothrombin time (PT), severe thrombocytopenia, malignant hypertension, and inability to meticulously supervise and monitor treatment. 

Absolute contraindications to warfarin include active bleeding, hemorrhagic tendencies, pregnancy, and a history of warfarin-induced skin necrosis. It should be used with great caution in patients with a history of GI bleeding, recent neurosurgery, alcoholic liver disease, severe renal... 

Prompt stabilization and aggressive fluid resuscitation of patients with active bleeding are followed by endoscopic examination. Airway management is critical. 

Bleeding during anticoagulant therapy does not always correlate with prothrombin activity. Bleeding that occurs when the PT or INR is within the therapeutic range warrants investigation because it may unmask a previously unsuspected lesion (eg, tumor, ulcer). 

Diagnosis is established by a combination of clinical examination (variceal bleeding is unlikely in the absence of stigmata of liver disease) and endoscopy. Bleeding ulcers may then be recognised as actively bleeding, or though the presence of a black base to the ulcer with, occasionally a visible vessel. 

Active bleeding. Acutely bleeding varices can be treated by injection sclerotherapy, by tamponade and by infusion systemically of vasopressin analogues or octreotide (which reduce variceal pressure). Results of controlled trials generally reflect efficacy in oesophageal rather than gastric variceal disease, which form a minority of cases, and can be more difficult to manage. 

That initial assessment should consider whether diarrhoea is watery, or sugar or fat malabsorptive, or whether there is active bleeding or significant abdominal pain suggesting inflammatory disease. In the elderly constipation with overflow may be the real problem, and the possibilities of partial mechanical obstruction and neoplasia must be born in mind. 

The contraindications to the use of thrombolytic drugs are similar to those for the anticoagulant drugs. Absolute contraindications include active bleeding, cardiopulmonary resuscitation (trauma to thorax is possible), intracranial trauma, vascular disease, and cancer. Relative contraindications include uncontrolled hypertension, earlier central nervous system surgery, and any known bleeding risk. 

Contraindications Active bleeding, coagulation disorders, severe hepatic disease... 

Contraindications Hypersensitivity to natural or recombinant hirudins (anticoagulation factors), active bleeding, irreversible coagulation disorders... 

Anticoagulant effect of warfarin maybe reversed by administration of vitamin Kor fresh frozen plasma should only use in situations where INR is severely elevated >10, or when patient is actively bleeding... 

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