disseminated intravascular coagulation

[versastyle]

hi, all i encounter this problem.

diagnosis. disseminated intravascular coagulation!!

so when this happen to what i know is that the pt ptt/ platelet will drop . the platelet count is bout 135k. the pt ptt is prolong slightly.

so when i focus in nursing writing, am i ok to say that

focus nursing intervention

prolong pt ptt timing. ffp 1 pint given.

but the main thing is i still don understand y give ffp if the platelet is low n the clotting time is prolong. y not give more platelet so that more platelet will be able to clot faster??

can someone help ans this qs. was grilled today by seniors. very sad.

[ERRNTraveler, RN]

FFP is a volume expander, so it will replace volume lost due to bleeding from the DIC, and will also aid in clotting.

By the way, as far as school goes, administering FFP is not a nursing intervention, it is a medical intervention carried out by nurses, since FFP cannot be given without a medical order. A nursing intervention would be to monitor for signs of bleeding &/or hypovolemia.

[leslie :-D]

doctors are not totally unified in what to prescribe for dic.

some will order platelets while others order ffp or cryoprecipitate.

but it is my understanding that generally:

platelets- correct overall thrombocytopenia

cryoprecipitate- replaces fibrinogen and factor viii;

and ffp- increases levels of other clotting factors and the natural anticoags.

but, you there is nothing across the board that concretely endorses one over the other.

leslie

[TiredMD]

the platelet count is bout 135k.

There are a variety of cutoffs we will use to transfuse platelets, depending on symptoms and underlying comorbidities. But 135k is above all of them.

[Elvish, BSN, DNP, RN, NP]

There are a variety of cutoffs we will use to transfuse platelets, depending on symptoms and underlying comorbidities. But 135k is above all of them.

I was wondering about that count too.

[Daytonite, BSN, RN]

dic (disseminated intravascular coagulation) occurs when there is a foreign protein that enters the circulation or there is a vascular endothelial injury of some sort. there is activation of prothrombin which results in an excess of thrombin. the thrombin converts fibrinogen to fibrin which produces fibrin clots in the microcirculation. this process uses up huge amounts of coagulation factors, in particular, fibrinogen, prothrombin, platelets, and factors v and viii. the result is hypofibrinogenemia, hypoprothrombinemia, thrombocytopenia and deficiencies of factors v and viii. the circulating thrombin activates the fibrinolytic system which dissolves fibrin clots into fibrin degradation products. it is believed that the resulting hemorrhage is the result of the anticoagulant activity of fibrin degradation products as well as depletion of the plasma coagulation factors.

the main treatment is to fix the underlying cause. blood, fresh frozen plasma, platelets or packed rbcs (red blood cells) are given to promote hemostasis.

fresh frozen plasma contains all the clotting factors and not just platelets. as you can tell from what i have listed above, dic causes a deficiency of not only platelets but many of the other clotting factors as well and these need to be replaced also. so, ffp is the best choice to transfuse.

here is a chart of commonly transfused blood products that tells you what is in them and why they are used:

• [attach]5812[/attach] chart of commonly transfused blood products