![]() ![]() ![]() Intravenous vitamin K 1 achieves a more rapid response compared with oral administration, with an onset of action of around 6 to 8 hours however, both routes have a similar effect on INR by 24 hours. It is used for patients with high INRs (without bleeding) or those with active bleeding. Phytomenadione or vitamin K 1 (Konakion) can be given to reverse the anticoagulant effect of warfarin. A reduction in Hb ≥ 20 g/L and/or transfusion of ≥ 2 units of red cells.Hypotension not responding to resuscitation.Need for invasive or surgical procedures. ![]() Initial management of an elevated INR in the ED depends on: High INR with no bleeding can often be managed in the community or in the short stay unit of the emergency department given appropriate risk assessment. The reason for an elevated INR needs to be investigated and addressed. High INR from warfarin can occur for many reasons. ![]()
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