Clinicians’ top priority when treating traumatic injuries is almost always to control bleeding. But complications can arise. For some patients, blood clots can form at the site of an injury. What’s more, a growing number of trauma patients in emergency departments have pre-existing medical conditions treated with anticoagulation therapy (ACT), which thins the blood and can increase bleeding.
“When a trauma patient has a history of blood clots, you may want to start therapeutic anticoagulation after an injury as soon as possible,” said Kazuhide Matsushima, M.D., associate professor of clinical surgery with the Keck School of Medicine of USC. “But you have a dilemma because if you start those blood-thinning medications right away, the patient can develop complex complications.”
Clinicians balance the risk of increased bleeding complications versus the risk of venous thromboembolism or other conditions when determining whether and when to initiate or resume anticoagulant therapy after a traumatic injury. Guidelines for clinicians are lacking, and practice patterns vary widely…
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