A 60-year-old man on warfarin for atrial fibrillation presents after a fall with GCS 14. CT head shows a chronic subdural hematoma with 5 mm midline shift. INR is 3.5. What is the most urgent intervention?
- A Oral vitamin K
- B Prothrombin complex concentrate ✓
- C Fresh frozen plasma
- D Platelet transfusion
Correct answer: B. Prothrombin complex concentrate
Explanation
Prothrombin complex concentrate is the fastest and most effective agent for reversing warfarin in intracranial hemorrhage, achieving correction within minutes with a small volume. FFP works more slowly and requires large volumes. Vitamin K takes hours to work and is adjunctive, not emergent. Platelets are not indicated here.
Reference: Harrison's Principles of Internal Medicine, 21st ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.