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Rivaroxaban has a higher risk of clinically relevant bleeding compared to apixaban during a 3-month treatment period for acute venous thromboembolism.
Source
Bleeding Risk with Apixaban vs. Rivaroxaban in Acute Venous Thromboembolism. N Engl J Med. 2026 Mar 12;394(11):1051-1060. doi: 10.1056/NEJMoa2510703. PMID: 41812192.
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In cases of severe traumatic hemorrhage, prehospital whole blood (WB) transfusion did not outperform component therapy in reducing mortality or need for massive transfusion within 24 hours.
Source
Prehospital Whole Blood in Traumatic Hemorrhage – a Randomized Controlled Trial. N Engl J Med. 2026 Mar 17. doi: 10.1056/NEJMoa2516043. Epub ahead of print. PMID: 41841706.
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A meta-analysis of over 70,000 patients found that non-vitamin-K antagonists (NOACs) were slightly more effective at preventing systemic embolic events (SEE) than warfarin in patients with atrial fibrillation (AF).
Source
Systemic Embolic Events in Atrial Fibrillation: An Individual Patient Data Meta-analysis of 71 683 Participants Randomized to NOAC Versus Warfarin. Circulation. 2026 Feb 24;153(8):567-575. doi: 10.1161/CIRCULATIONAHA.125.075275. Epub 2026 Jan 30. PMID: 41614257.
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Platelet transfusion in patients with traumatic brain injury (TBI) on antiplatelet agents was not associated with change in mortality or hemorrhage progression and was associated with longer hospital stays.
Source
Should platelet transfusion be used to reverse preinjury antiplatelet agents in traumatic brain injury? A systematic review and meta-analysis. The journal of trauma and acute care surgery. 2026. PMID: 41532957
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Antithrombotic medication reversal in traumatic brain injury (TBI) is a nuanced topic, requiring assessments of injury severity, appropriate reversal agent and dosing strategy, and potential risks to the patient.
Source
Reversal of antithrombotic medications in patients with traumatic brain injury: What you need to know. J Trauma Acute Care Surg. 2025 Dec 1;99(6):828-835. doi: 10.1097/TA.0000000000004766. Epub 2025 Aug 19. PMID: 40828405.
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For pediatric patients presenting with acute sickle cell pain, receiving a first dose of pain medications within one hour of ED arrival and second dose within the next half hour was associated with reduced need for hospitalizations.
Source
Opioid Timeliness in the Emergency Department and Hospitalizations for Acute Sickle Cell Pain. JAMA Pediatr. 2025 Sep 2:e252967. doi: 10.1001/jamapediatrics.2025.2967. Epub ahead of print. PMID: 40892426; PMCID: PMC12406144.
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A transfusion trigger of less than 10g/dL appears to lower 30-day mortality in patients with acute myocardial infarction (AMI).
Source
Red Cell Transfusion in Acute Myocardial Infarction: AABB International Clinical Practice Guidelines. Ann Intern Med. 2025 Aug 19. doi: 10.7326/ANNALS-25-00706. Epub ahead of print. PMID: 40825204.
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A restrictive platelet transfusion strategy was better in most clinical scenarios. Here are the latest guidelines in brief.
Source
Platelet Transfusion: 2025 AABB and ICTMG International Clinical Practice Guidelines. JAMA. 2025 Aug 19;334(7):606-617. doi: 10.1001/jama.2025.7529. PMID: 40440268.
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If you have access to the common massive transfusion protocol (MTP) cooler construct of 6:6:1 PRBCs:FFP:platelets, cryoprecipitate should be used at about the start of the second cooler.
Source
Where does cryoprecipitate fit into balanced resuscitation? An evaluation of 2,117 hemorrhaging patients using viscoelastic-based resuscitation. J Trauma Acute Care Surg. 2025 Jul 1;99(1):73-78. doi: 10.1097/TA.0000000000004643. Epub 2025 Apr 17. PMID: 40249632
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Not everything that can bleed will bleed. This retrospective study of elderly mild-TBI patients showed no significant association between antithrombotic medication use and risk of traumatic ICH.
Source
Association between antithrombotic medications and intracranial hemorrhage among older patients with mild traumatic brain injury: a multicenter cohort study. Eur J Emerg Med. 2025 Jul 1. doi: 10.1097/MEJ.0000000000001246. Epub ahead of print. PMID: 40590793