Management of the Over-anticoagulated Patient Case 2

A 78-year-old lady is brought into the resuscitation room by the paramedics with increased confusion following an unwitnessed fall up to 6hrs previously. They tell you she was found at the bottom of the stairs in her own home, with a GCS of 13 (E4V4M5). Her daughter tells you she was last seen 6hrs ago by herself after a shopping trip, and is normal very independent and orientated.

Her observations are largely unremarkable, with BP 140/85, HR irregularly-irregular 95, ECG shows AF, Sats 97% on air,  GCS is unchanged at 13 and PERL. On examination she has a bruise over the left temporal area, and no other evidence of injury.

What single piece of information would you like to know that may help you with your diagnosis?

You find out she takes bisoprolol, rampril and warfarin, and has a past medical history of AF, hypertension, diet controlled diabetes and pernicious anaemia.

Which three of the following test are the most appropriate?

Which two of the following are the agents of choice for immediate reversal?