What is the initial management for direct oral anticoagulant (DOAC) overdose if it is within 1 hour?

The initial management for a direct oral anticoagulant (DOAC) overdose within 1 hour is to administer activated charcoal. Activated charcoal works by binding to the anticoagulant in the gastrointestinal tract, thereby reducing its absorption into the bloodstream, which is crucial in the immediate management of the overdose. Since DOACs are often taken orally, this approach can effectively mitigate their anticoagulant effects if done soon after ingestion.

In situations where anticoagulants have recently been absorbed, activated charcoal is a key intervention to prevent further anticoagulant activity. Other treatments such as protamine sulphate are specific for reversing the effects of heparin, not DOACs. Warfarin is another anticoagulant and would be inappropriate in an overdose scenario. Benzodiazepines, while useful for managing anxiety or agitation, do not address the anticoagulation aspect and are not indicated in this context. Thus, the choice of activated charcoal is clearly the best option for managing a recent DOAC overdose.