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Mechanical methods of hemostasis may be necessary, including direct compression, surgery, or embolization. Providers should remember that all patients with emergent or life-threatening bleeding require attention to basic interventions, including cessation of anticoagulation therapy, blood product transfusions, and assessment for airway protection. We will review physiologic hemostasis processes, the effect of anticoagulation on normal hemostasis, and then discuss each anticoagulant and its reversal. 3 Owing to the propensity of anticoagulated patients to bleed, a strategy for reversal of anticoagulation induced by any of the common agents is essential for the treating clinician. Compared to warfarin, these drugs have generally been associated with lower rates of major hemorrhage and a reduction in the risk of fatal bleeding and intracranial hemorrhage (ICH). 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