Please enable JavaScript.
Coggle requires JavaScript to display documents.
Disseminated intravascular coagulation (DIC) (Aetiology (Trauma Major…
Disseminated intravascular
coagulation (DIC)
Pathophysiology
Mechanism
Widespread fibrin deposition in the microvasculature
Coagulation factors and Plts become consumed
No longer able to coagulate, become haemorrhagic
Triggers
One of many possible triggers stimulate
extrinsic coagulation cascade via tissue factor
Aetiology
Trauma
Major blood loss i.e hypovolemic shock
Burns
Neoplastic
Malignancy
Infection
Sepsis
Endocrine
Pregnancy (pre-eclampsia, retention of dead foetus,
placental abruption, endotoxic shock, amniotic fluid embolism, placenta accreta, molar pregnancy)
Clinical
presentation
Purpura
Haemorrhage
Bruising
Diagnosis
Examination
Derm exam
Petechiae, purpura, bruising
Investigations
Bloods
FBC (low Plt, may have low Hb), U+E, LFT,
clotting (prolonged PT/APPT), fibrinogen (low), D-dimer (high),
G+S, crossmatch
Blood cultures (sepsis)
Imaging
Suspected internal haemorrhage
Bedside
Obs (shock, ?fever)
History
DH
Meds, allergies
SH
Living arrangements, occupation,
smoking, alcohol
PMH
Known medical conditions
Coagulopathy
PC/HPC
Trauma, recent infection,
pregnancy, etc
Management
Initial ABCDE
Definitive
Conservative
Identify and treat cause
Medical
Transfusions
E.g. FFP, platelets, packed red cells,
cryoprecipitate
Protein concentrates
E.g. antithrombin, protein C
Definition
Acquired coagulopathy
with initial clotting then bleeding
Epidemiology
Any age
High mortality