title: Superwarfarin ingestion treated successfully with prothrombin complex concentrate.
abstract: Superwarfarin, a common component of rat poison, can cause long-lasting, severe coagulopathy and life-threatening hemorrhage when ingested. We report a case of intentional rat poison consumption with subsequent hemorrhage and hypotension requiring rapid coagulopathy reversal and resuscitation in the emergency department. In addition to traditional blood products, prothrombin complex concentrate was administered. Although prothrombin complex concentrate is increasingly used for severe hemorrhage in anticoagulated patients, it may be particularly useful in superwarfarin ingestions given the extreme, persistent coagulapathies that can occur.
authors.affiliation: Division of Emergency Medicine, University of Washington School of Medicine, Seattle, WA.
authors.forename: Olivia
authors.initials: O
authors.lastname: Haesloop
authors.affiliation: Department of Medicine, University of Washington School of Medicine, Seattle, WA.
authors.forename: Allison
authors.initials: A
authors.lastname: Tillick
authors.affiliation: Department of Medicine, University of Washington School of Medicine, Seattle, WA.
authors.forename: Graham
authors.initials: G
authors.lastname: Nichol
authors.affiliation: Division of Emergency Medicine, University of Washington School of Medicine, Seattle, WA. Electronic address: strote@uw.edu.
authors.forename: Jared
authors.initials: J
authors.lastname: Strote
mesh_terms: D000925:Anticoagulants / Q000506:poisoning*; D001779:Blood Coagulation Factors / Q000627:therapeutic use*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011041:Poisoning / Q000175:diagnosis* / Q000628:therapy*; D014812:Vitamin K / Q000627:therapeutic use*; D014859:Warfarin / Q000506:poisoning*
chemical_list: D000925:Anticoagulants; D001779:Blood Coagulation Factors; D014812:Vitamin K; C025667:prothrombin complex concentrates; D014859:Warfarin