Anticoagulation in the Emergency Department: A Case-Based Approach to Managing Patients with Venous Thromboembolism and Nonvalvular Atrial Fibrillation
Release Date: February 26, 2016
Last Reviewed: February 9, 2016
Expiration Date: February 26, 2017
Time to Complete Activity: 1.5 hours

*This activity expired for credit on February 26, 2017 and is no longer available for credit
This activity is provided by Global Education Group.  Paradigm Medical Communications, LLC is the educational partner.
In collaboration with the Hospital Quality Foundation.

Reviewed and approved for distribution by The Journal of Emergency Medicine.

Charles V. Pollack, Jr., MA, MD, FACEP, FAAEM, FAHA, FESC, FCPP (Chair)
Associate Provost for Innovation in Education
Thomas Jefferson University
Director, Jefferson Institute of Emerging Health Professions
Associate Dean for CME and Strategic Partner Alliances
Thomas Jefferson University
Professor and Senior Advisor for Interdisciplinary Research and Clinical Trials, Department of Emergency Medicine 
Sidney Kimmel Medical College of Thomas Jefferson University
Philadelphia, PA 
Elaine Hylek, MD, MPH
Professor of Medicine
Thrombosis Clinic and Anticoagulation Service
Boston University School of Medicine
Boston, MA
David E. Slattery, MD, FACEP, FAAEM
Associate Professor
Director of Research
Department of Emergency Medicine
University of Nevada School of Medicine
Las Vegas, NV
Target Audience
This activity has been designed to address the educational needs of emergency medicine physicians and other clinicians who work in the emergency department who are involved in anticoagulation management. It may also be of benefit to other emergency medicine professionals, critical care specialists, hospitalists, pharmacists, physician assistants, nurse practitioners, and other healthcare professionals involved in the management of patients with venous thromboembolism and atrial fibrillation in the hospital setting.
Learning Objectives
Upon proper completion of this activity, participants should be better able to:
  • Describe the differences among available anticoagulants, including warfarin and non-warfarin oral anticoagulants, and their appropriate use in patients with venous thromboembolism.
  • Design individualized strategies for stroke prevention in patients with atrial fibrillation using current guidelines and clinical evidence.
  • Describe current and emerging reversal agents to manage bleeding in patients treated with oral anticoagulants.
Table of Contents
  1. Introduction
  1. OACs for the Treatment and Prevention of DVT/PE
  1. Recognition and Anticoagulation in Patients with New Onset NVAF
  1. Reversal, Repletion, Antidotes: What to Do When We Have a Problem
  1. Conclusion
Physician Accreditation Statement
Global Education Group is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.

This CME/CE activity complies with all requirements of the federal Physician Payment Sunshine Act. If a reportable event is associated with this activity, the accredited provider managing the program will provide the appropriate physician data to the Open Payments database.
Physician Credit Designation Statement
Global Education Group designates this enduring material for a maximum of 1.5 AMA PRA Category 1 Credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.
ACEP Category I Credit Statement
Approved by the American College of Emergency Physicians for a maximum of 1.5 hours of ACEP Category I credit.

Physician Assistant Continuing Education
AAPA accepts certificates of participation for educational activities certified for AMA PRA Category 1 Credit™ from organizations accredited by ACCME or a recognized state medical society. Physician assistants may receive a maximum of 1.5 hours of Category 1 credit for completing this program.
Nurse Practitioner Continuing Education
The American Academy of Nurse Practitioners Certification Program (AANPCP) accepts certificates of participation for educational activities certified for AMA PRA Category 1 Credit™ from organizations accredited by the ACCME.  Individuals are responsible for checking with the AANPCP for further guidelines.
For information about the accreditation of this program, please contact Global at (303) 395-1782 or
Disclosure of Commercial Support
This activity is supported by an independent educational grant from Boehringer Ingelheim Pharmaceuticals, Inc.
Instructions for Participation
To receive a CME certificate of participation, participants must:
  • Follow instructions to register or log in with your professional information and complete the pretest.
  • View the online activity in its entirety.
  • Complete and submit the online posttest and evaluation. You must answer 70% of the posttest questions correctly to earn credit. You will have unlimited opportunities to successfully complete the posttest.
A certificate of participation will be available for download/printing immediately following your successful completion of the posttest and evaluation.
For questions regarding CME credit, contact the Paradigm CME Department at (845) 398-5949.

There is no fee required for participation in this activity.
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This certified CE activity is designed using HTML5 audio.
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For desktops (Windows/Mac)
Internet Explorer 9 or higher, Firefox 28 or higher, Safari 5.1 or higher, Google Chrome 31 or higher, Opera 21 or higher
For Tablets (iPad/Android/Surface)
iOS Safari 4 or higher, Android 2.3 or higher, IE Mobile 10 or higher
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Disclosure and Resolution of Conflict of Interest
Global Education Group (Global) and Paradigm Medical Communications, LLC (Paradigm) require instructors, planners, managers, and other individuals and their spouse/life partner who are in a position to control the content of this activity to disclose any real or apparent conflict of interest they may have as related to the content of this activity.  All identified conflicts of interest are thoroughly vetted by Global and Paradigm for fair balance, scientific objectivity of studies mentioned in the materials or used as the basis for content, and appropriateness of patient care recommendations. 
The faculty reported the following financial relationships or relationships to products or devices they or their spouse/life partner have with commercial interests related to the content of this CME activity:
Name of Faculty or Presenter
Reported Financial Relationship
Charles V. Pollack, Jr., MA, MD, FACEP, FAAEM, FAHA, FESC, FCPP
Retained Consultant: Boehringer Ingelheim Pharmaceuticals, Inc,
Bristol-Myers Squibb Company/Pfizer Inc, Daiichi Sankyo, Inc, Janssen Pharmaceuticals, Inc
Elaine M. Hylek, MD, MPH
Retained Consultant: Armetheon, Inc, Bayer Healthcare, Boehringer Ingelheim Pharmaceuticals, Inc, Bristol-Myers Squibb Company, Daiichi Sankyo, Inc, Janssen Pharmaceuticals, Inc, Medtronic, Pfizer Inc
Honoraria: Bayer Healthcare, Boehringer Ingelheim Pharmaceuticals, Inc, Bristol-Myers Squibb Company
David E. Slattery, MD, FACEP, FAAEM
   No financial relationships to disclose

The planners and managers reported the following financial relationships or relationships to products or devices they or their spouse/life partner have with commercial interests related to the content of this CME activity:
Name of Planner or Manager
Reported Financial Relationship
Amanda Glazer, PhD
No financial relationships to disclose
Laura Gilsdorf
No financial relationships to disclose
Paradigm Medical Communications, LLC staff members have no financial relationships to disclose.
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This educational activity may contain discussion of published and/or investigational uses of agents that are not indicated by the FDA. Global and Paradigm do not recommend the use of any agent outside of the labeled indications. 
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Participants have an implied responsibility to use the newly acquired information to enhance patient outcomes and their own professional development. The information presented in this activity is not meant to serve as a guideline for patient management. Any procedures, medications, or other courses of diagnosis or treatment discussed in this activity should not be used by clinicians without evaluation of patient conditions and possible contraindications on dangers in use, review of any applicable manufacturer’s product information, and comparison with recommendations of other authorities.

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