How are serious bleeding complications from thrombolytic therapy managed?

Updated: Dec 31, 2017
  • Author: Wanda L Rivera-Bou, MD, FAAEM, FACEP; Chief Editor: Erik D Schraga, MD  more...
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Answer

Answer

If a patient who was treated with fibrinolytic medications develops serious bleeding complications, the first step is to stop the fibrinolytic agent and any anticoagulants. The next step is to institute supportive therapy, often including volume repletion and transfusion of blood factors. When possible, direct pressure should be used to control bleeding. If the patient has also been receiving heparin, protamine sulfate may be used to reverse the heparin effect. Each 1 mg of protamine sulfate neutralizes approximately 100 U of heparin.


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