Which specialist consultations are beneficial to patients with warfarin and superwarfarin toxicity?

Updated: Jan 19, 2018
  • Author: Kent R Olson, MD, FACEP; Chief Editor: David Vearrier, MD, MPH  more...
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Since most warfarin and superwarfarin exposures result in minor or no significant effects, regional poison control centers can aid in decreasing the referral of patients to health care facilities and in reducing the performance of unnecessary laboratory tests in minor, unintentional exposures. The poison centers and clinical toxicologists may be helpful in evaluating a large anticoagulant overdose and can assist with long-term follow-up care after ingestion of a superwarfarin.

Obtaining a psychiatric referral is appropriate for intentional ingestions. Contact child welfare or protective services if child abuse is suspected.

The patient's primary care provider or the local coagulation clinic is an appropriate referral if an unintentional overdose occurs and the patient is considered to be at low risk for bleeding complications.

Consulting a neurosurgeon is appropriate for intracranial hemorrhage. Consulting a gastroenterologist is appropriate for gastrointestinal hemorrhage.

If the patient has any type of hemorrhage that the current facility is not capable of managing appropriately, transfer to a higher level of care is indicated.

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