This article covers risk factors associated with falling when using blood thinners, as well as what you should do when you fall.

Anticoagulant Therapy

Your health care provider may have started you on a medicine known as an ANTICOAGULANT to help reduce the chance of a blood clot. Anticoagulants are sometimes called blood thinners. The most common places for blood clots to form are in your legs, your lungs, or your heart. Blood clots can travel through your blood stream to other places in your body, such as your brain or heart. A blood clot to your brain can cause a stroke, and a clot that blocks blood flow to the heart can cause a heart attack. Heparin and Warfarin (Coumadin) are common anticoagulant medicines.

Clopidogrel (Plavix) and aspirin are antiplatelet medicines, another kind of blood thinner. Platelets help your blood to clot. If the platelets are too active, this can lead to a heart attack or stroke, as described above.

When you are on blood thinners, your health care provider may monitor the time it takes your blood to clot. These tests are very important to minimize the most common side effects of bruising and bleeding that can occur from taking an anticoagulant or anti-platelet medicine. Some blood thinner medications do not require monitoring your healthcare provider will let you know which require monitoring.

Common Blood Thinner or Anti-platelet Drugs:

  • Coumadin (Warfarin)
  • Effient (prasugrel)
  • Eliquis (apixaban)
  • Lovenox (enoxaparin)
  • Plavix (clopidogrel)
  • Pradaxa (dabigatran)
  • Xarelto (rivaroxaban)
  • Brilinta (ticagrelor)
  • Aggrenox (ASA and dipyridamole)
  • Heparin

Results of a Fall

When you fall, you may hit objects on the way down such as furniture, doorways, etc. Every part of your body that hits something when you fall may experience bleeding. Being on a blood thinner can worsen the effects of a fall, causing bleed or even a bone fracture. Bleeding can be life- threatening, which is important to remember when you experience any fall.

When you are taking blood thinners, bleeding may be more extensive and/or last a long time. This can lead to changes in your body systems, including your blood pressure, pulse and breathing. This happens because your blood will be leaking outside of the arteries and veins, and bleeding into your body tissues.

What to Do if You Fall

Here are some tips to protect your life and health by knowing what to do if you happen to fall.

Not Bleeding

If you fall and you are not obviously bleeding, tell your provider about the fall and the name of the anticoagulant or antiplatelet medication you are taking. If you hit your head with or without loss of consciousness you must let your provider know that you fell. The only way that your healthcare provider can help you is for you to report your fall.

Remember, just because you don't see any bleeding, you could be bleeding into your body tissues and you need to monitor the area of the body impacted by the fall. Mark that part of the body by putting a circle around the area. To monitor the speed of bleeding into your tissues check the sites every 3-5 minutes, and mark new circles where the bruising has expanded. If you find that your bruising continues to increase in size, either go to an emergency room or call 911 for help.

Actively Bleeding

If you fall and are actively bleeding, apply pressure directly to the site that is bleeding, and either call 911 or ask a family member to call. Do not wait to call. If you think that the bleeding is not enough to call 911, call your local emergency room, and ask the nurse what to do.

Whatever your decision, your first action is to call for medical help. Do not delay. Emergency responders can quickly get you into a healthcare system that can administer medications to control bleeding that may protect your life.

Protecting Yourself in All Situations

These simple steps may protect your life:

  1. Wear a medical alert bracelet at all times that indicates you are taking anticoagulant or anti-platelet medicine.
  2. Carry a list of your current medication (prescribed and over-the-counter) on your person when you are out of the house. You could keep a copy of this list in your wallet or purse. Make sure this list is the same as the one you keep in your home for emergency personnel.
  3. On your medication list, include the name and phone number of your healthcare provider, in case a stranger or emergency paramedic needs to call them.
  4. If you require a mobility aid (such as a cane or walker) for safe transfers and/or walking, be sure to use your mobility aids as prescribed. These devices are prescribed to help you walk safely.
  5. Treat all falls as serious. Call your healthcare provider and report your fall, even if you think that you were not hurt.

For Family Members of a Person Taking Blood Thinners who Has Fallen:

  1. Check for injury and bleeding. DO NOT get the person up until you are certain there is no serious injury or bleeding.
    • Are they breathing? If not, call 911 and start CPR.
    • If the person is confused, talk to them and orient them to the situation.
    • Are they bleeding? If yes, put pressure on the site of the bleeding, call 911 and inform them that the person takes an anticoagulant or antiplate let medicine.
    • Did they lose consciousness? Are they more confused? If yes, call 911.
    • Where do they hurt? Ask the person if they have pain anywhere. Look for any obvious fractures. Do NOT get the person up. Call 911 for help.
  2. Do not attempt to lift the person by yourself. Trying to lift a person can injure both of you.
  3. Reassure the person. They may be confused, frightened, and embarrassed. If possible, provide a calm environment, cover them with a blanket, and stay until help arrives.
  4. Ask for details about the fall, and get as much information as possible from any witnesses.
  5. Ask the person how long they have been taking blood thinners, what kind, and the last time they took their medication.
  6. As soon as possible notify the person's healthcare provider about the fall. A fall can be a symptom of serious problems. Most falls can be prevented.