Anticoagulation complexity referral checklist

Referral checklist for recurrent bleeding risk, dosing complexity, or persistent anticoagulation uncertainty.

Last reviewed February 7, 2026

Urgency tier

Immediate emergency assessment for major active bleeding or clinical instability; do not wait for referral paperwork or routine tests.
Head injury while anticoagulated requires prompt ED assessment even if initially well.
Expedited referral for recurrent clinically significant bleeding, severe renal decline, or recurrent thrombosis.
Routine referral for persistent dosing uncertainty without acute instability.

Minimum pre-referral workup

Confirm indication, treatment start date, and current anticoagulant regimen.
Provide recent CBC, renal function, and clinically relevant liver results.
Document bleeding history, thrombosis history, and current interacting medications.

Referral packet checklist

Clear clinical question for specialist input.
Complete medication list with start dates and recent changes.
Most recent objective data (labs, imaging, event timeline).

Pre-referral optimization tasks

Pause non-essential interacting medications where clinically safe.
Reinforce bleeding precautions and return instructions.
Confirm close follow-up while waiting for specialist review.

References

Something out of date or unclear? Suggest an update. Leave out any patient details.