What is the priority for a 73-year-old patient on warfarin, who is now vomiting with a GCS of 14 and BP of 170/90?

The priority for a 73-year-old patient on warfarin who is vomiting, with a Glasgow Coma Scale (GCS) of 14 and a blood pressure of 170/90, is to ensure rapid transport to a stroke center. This patient’s age and history of anticoagulation therapy put them at increased risk for bleeding complications, including intracranial hemorrhage, especially if they are experiencing vomiting, which could indicate a potential underlying issue.

The risk factors of advanced age and anticoagulation highlight the need for urgent evaluation, particularly for the possibility of a stroke or other serious complications. Rapid transport allows for immediate access to diagnostic imaging and specialized care that are critical for managing stroke and bleeding emergencies.

While TXA is used for treating certain types of bleeding, it's typically administered in cases of significant hemorrhage or trauma; in this scenario, assessment and diagnostic measures are more pressing. Activated charcoal would be relevant if there were a concern regarding poisoning or overdose; however, the context here indicates an acute medical situation rather than a toxic ingestions issue. Hyperventilation is generally not a treatment strategy unless there are specific indications such as severe respiratory distress or certain medical conditions.

Thus, prioritizing transport to a stroke center enables timely intervention