Clotting and anti-clotting mechanisms occur at the same time. Small clots in certain areas of the body are using the clotting factors and other areas do not have any clotting factors so bleeding occurs.

Bleeding and clotting

Internal and external bleeding. Microclots can lead to organ ischemia. Life-threatening

Causes

Sepsis. Hemorrhage. Blood transfusions. Pregnancy complications. Tauma. Shock. Toxins. Allergic reactions and malignancy

Symptoms

Bleeding and clotting. Bleeding. petechiae, hematuria, melena, & nose bleeds. Clotting: stroke, MI, DVT, & PE. Shortness of breath. Tachycardia. Organ damage such as kidneys & bowel. A very sick client

Management

Monitor labs: ⇓ platelets, ⇓ fibrinogen, ⇑ PT/PTT, & positive D-Dimer D-Dimer tells us that a clot is present somewhere in the body. Treat the cause

Transfusion: RBCs, Fresh frozen plasma, & platelets
Cryoprecipitate: replaces fibrinogen and factors V and VII
Vasopressors to increase organ perfusion
Best management is prevention.

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