“Fantastic reversal of warfarin!” exclaims your registrar who has been hovering in angel form over your right shoulder all this time. “I’ll sort out this upper GI bleed from here – it’s what the renal team are for!”

To quote from NICE guidance on upper GI bleeds:

Transfuse patients with massive bleeding with blood, platelets and clotting factors in line with local protocols for managing massive bleeding.

Base decisions on blood transfusion on the full clinical picture, recognising that over-transfusion may be as damaging as under-transfusion.

Offer prothrombin complex concentrate to patients who are taking warfarin and actively bleeding.

This patient actually had an upper GI bleed (recent onset black stools, with dropping Hb and rising urea in a patient on warfarin). You need to fluid resus, crossmatch around 4-6 units usually, reverse any anticoagulation and prepare for endoscopy.

https://www.nice.org.uk/Guidance/cg141