A 60yoM h/o A-Fib on Dabigatran, took his medication this morning and then slipped in the shower 10 mins later, hitting his head with +LOC. He did not want to come to the emergency room at first but approximately 14 hours later, complains of worsening headache, nausea, and vomiting. CT shows a parietal subdural hematoma. What should be the primary means of reversal for this patient’s anticoaguation.

Answer: Discontinuing the medication. The half-life of dabigatran is 14-17 hours. Hemodialysis can be considered as a last resort but would not be necessary in this case.