The VBG shows:

Hb 64 g/l

Lactate 3.5 mmol/L

You start a transfusion of red blood cells along with the fluids. Meanwhile, you await the FBC and coagulation screen.

Once the patient is more stable, you speak to your consultant about an endoscopy. She is on her way…but asks you to confirm the warfarin has been reversed.

You check with the FY1…who has reversed warfarin using oral vitamin K.

You quickly issue prothrombin complex (Factors II, VII, IX and X), IV vitamin K and apologise to your gastro consultant.