DIC: NCLEX Priorities
Disseminated intravascular coagulation: bleeding + clotting simultaneously, treat underlying.
DIC is widespread activation of clotting with consumption of factors. Bleeding and clotting at the same time.
Causes
Sepsis, trauma, obstetric (amniotic embolism, abruption), malignancy, snake envenomation.
Labs
Decreased platelets, prolonged PT/PTT, decreased fibrinogen, elevated D-dimer.
Recognition
Bleeding from venipuncture sites, gums, GI, GU. Petechiae. Plus organ dysfunction from microthrombi.
Treatment
Treat underlying cause. Supportive: FFP for coagulopathy, cryoprecipitate for low fibrinogen, platelets if bleeding, RBCs if anemic. Heparin controversial.
Frequently asked
Why heparin in a bleeding patient?
Controversial. Used when thrombosis dominates clinical picture (e.g., promyelocytic leukemia DIC).
OB DIC, common cause?
Placental abruption, amniotic fluid embolism, severe pre-eclampsia.
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