Blood in vomit, high fever with Covid+ve and CRP raised? All anticoagulants are contraindicated?


Blood in vomit in a covid positive pt Is it a single episode or frequent So far use of anticoagulants like enoxiparum has to be cautious with monitoring of PT PTT AND INR as high inflammatory markers demand the use of enoxiparum but you can consider oral Riroxuban if not contraindicated Is there bleed from elsewhere like urine stool etc think of DIC Yes rest of anticovid regime Inj Remdesivir Inj Tocilizumab And rest of supportive treatment Sos if Remdesivir is not available Consider Tocilizumab+favipiravir

Thanx dr Pushkar ji Bhomia

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Covid positive, high fever and raised CRP - consider Remdesivir Check D dimer, if raised then there is indication for anticoagulation In view of hematemesis , risk of anticoagulation to be balanced with need of anticoagulation based severity of Covid 19

No need of anticoagulant If spo2 less then 95 & hrct shows consolidation then only Lmwh is safe as per icmr guidence

See for Hb replacement only blood transfusion or packed red blood cells transfusion

CBC, platelets count, X-ray abdomen in erect posture, Blood for MP & Widal test. Cold Sponging sos, monitor pulse,BP & Hb% and decide for BT. Suitable parental Antibiotic,Inj.domperidon sos.

rule out DIC D dimer ? Sepsis is m/c of death in Covid 19 pt

Blood if once can be due to tear , if associated with retching and no prior history of liver d/o or coagulopathy, history is important and if anticoagulant already given monitor INR

Evaluate D dimer Stop anticoagulant Treatment according to protocol

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