Browse categories and answer follow-up questions to refine your symptom profile.
Immediate stabilization
Resuscitation priorities
Airway protection trigger
Ongoing massive hematemesis
GCS < 13
Shock triggers
SBP < 90 mmHg
MAP < 65 mmHg
Lactate rising
Large-bore access
2 peripheral IVs
Rapid infuser consideration
Hemorrhage control bundle
Mechanical compression for external bleeding
Tourniquet for uncontrolled extremity bleeding
Pelvic binder for suspected pelvic fracture
Massive transfusion activation triggers
Ongoing hemodynamic instability with suspected major bleed
Transfusion requirement escalating
Targets and monitoring
Physiologic targets
MAP ≥ 65 mmHg
Hemoglobin trend stabilization
Platelets ≥ 50 x 10^9/L for major bleeding
Platelets ≥ 100 x 10^9/L for intracranial bleeding or neurosurgery
Fibrinogen ≥ 1.5 g/L
Temperature ≥ 36 C
Ionized calcium within local reference range
Monitoring
Cardiac monitor
Rate and rhythm for shock physiology
Frequent vitals
Every 5-15 minutes during active resuscitation
Foley consideration
Urine output trend for shock
Arterial line trigger
Refractory shock
Vasoactive infusion
Anticoagulant identification and reversal triggers
Anticoagulant exposure classification
Vitamin K antagonist
Warfarin
Direct thrombin inhibitor
Dabigatran
Factor Xa inhibitor
Apixaban
Rivaroxaban
Edoxaban
Betrixaban
Heparins
Unfractionated heparin
Low molecular weight heparin
Indirect Xa inhibitor
Fondaparinux
Major bleeding definition
Hemodynamic compromise
Critical site bleeding
Intracranial
Intraspinal
Intraocular with vision threat
Pericardial
Airway
Retroperitoneal
Overt bleed with significant hemoglobin drop
Transfusion requirement
Reversal activation principles
Life-threatening bleeding
Immediate reversal pathway
Major bleeding
Reversal pathway plus source control
Non-major bleeding
Hold agent and supportive care pathway
Source control and consultation triggers
Source control pathways
GI bleeding
GI consult for endoscopy timing
Intracranial bleeding
Neurosurgery consult
Neurocritical care consult
Trauma
Trauma team activation
Pelvic or solid organ bleeding
Interventional radiology consult
Hematuria with clot retention
Urology consult
Postpartum or uterine bleeding
Obstetrics consult
Specialist triggers
Hematology consult
Unclear agent
Refractory coagulopathy
Suspected superwarfarin exposure
Poison center or toxicology consult
Unknown ingestion
Massive overdose
PITFALLS
Common errors
Reversal delay while awaiting definitive imaging in suspected intracranial bleed
Under-recognition of mixed antithrombotic therapy
Anticoagulant plus antiplatelet
Reliance on normal INR to exclude DOAC effect
Failure to correct hypothermia and hypocalcemia during massive transfusion
PEARLS
High-yield principles
Agent-specific reversal when available
PCC for warfarin-associated major bleeding preferred over plasma in many protocols
Dabigatran uniquely dialyzable compared with factor Xa inhibitors
Restart decision individualized after hemostasis and bleed site risk
SymptomDx is an educational tool for medical professionals. It does not replace clinical judgment. Verify all clinical data and drug dosages with authoritative sources.