Case scenario: emergency reversal of oral anticoagulation.

REVERSING warfarin-induced anticoagulation quickly and effectively can be challenging in medically compromised patients presenting for emergency surgery. Anticoagulation reversal poses a delicate balance between increasing the risk of clotting and decreasing the risk of intraoperative blood loss. Furthermore, variable individual responses and warfarin’s adverse effect profile render particular dosing challenges. Consequently, meticulous monitoring of anticoagulated patients with prothrombin time and international normalized ratio (INR) must guide titration. Traditionally, fresh frozen plasma (FFP) has been the mainstay of warfarin reversal. Herein, we present a case in which we administered prothrombin complex concentrate (PCC) instead of FFP to hasten INR correction, reduce volume requirements, and diminish immune-related risks.