What is the management for a patient on warfarin with an INR of 5-8 and minor bleeding?

The management of a patient on warfarin with an INR of 5-8 and minor bleeding involves stopping the warfarin and administering intravenous Vitamin K. This approach is appropriate because patients with elevated INR levels, particularly in the range of 5-8, have an increased risk of bleeding, and minor bleeding indicates that the anticoagulation effect of warfarin needs to be reversed safely and effectively.

Administering 1-3 mg of IV Vitamin K allows for rapid reversal of the anticoagulation effects of warfarin, while the decision to stop warfarin ensures that further anticoagulation does not exacerbate the bleeding. This management strategy strikes a balance between addressing the immediate risk of bleeding and minimizing the duration of elevated INR.

Continuing warfarin and monitoring INR would not be appropriate given the elevated INR and the presence of bleeding, as this could lead to further complications. Administering a blood transfusion is not indicated for minor bleeding with elevated INR, and increasing the warfarin dose would further increase the risk of bleeding, contrary to what is necessary in this situation. Thus, stopping the warfarin and administering Vitamin K is the most effective and safest management.