6 surgical hemostasis
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This document discusses surgical hemostasis. It begins by outlining the learning objectives, which are to understand what hemostasis is, the causes of excessive bleeding during or after surgery, and how to evaluate a patient's hemostasis before surgery. It then defines hemostasis as the arrest of blood escape through natural or artificial means. It describes the natural hemostasis process involving vasoconstriction, platelet plug formation, and blood clot formation. It lists the 12 clotting factors and the intrinsic and extrinsic clotting pathways. The document concludes by discussing causes of bleeding during or after surgery, including defects of hemostasis, and the steps of pre-operative evaluation of a patient's hemost
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02a Surgical hemostasis
This document discusses hemostasis in surgical patients. It begins by defining hemostasis as the state of fluid equilibrium within blood vessels. It then describes the two mechanisms of hemostasis - primary hemostasis involving vasoconstriction and platelet plug formation, and secondary hemostasis involving activation of the coagulation cascade and formation of a fibrin clot. The document outlines the coagulation cascade and its natural inhibitors. It discusses various defects of hemostasis, preoperative screening tests for bleeding risk, and strategies to achieve surgical hemostasis including direct pressure, cauterization, packing, topical hemostats, and fibrin glue.
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This document discusses perioperative bleeding and homeostasis. It begins with defining bleeding and describing different types. It then covers preoperative bleeding risk assessment, including medication and bleeding history, physical exam, and tools to evaluate risk. Methods of achieving homeostasis during and after surgery are outlined, including mechanical, thermal, pharmacological, and TEG monitoring. Predictors of postoperative bleeding in cardiac surgery and guidelines for assessing bleeding risk from British and European societies are presented.
Management of Surgical Hemostasis: An Independent Study Guide
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Effective management of hemostasis during surgery is critical for the patient. Using the nursing process and evidence-based practices, this independent study program will assist the perioperative RN identify risks, benefits, indications, contraindications, and adverse effects for the various methods available for control of bleeding during surgery. The goal of this learning activity is to educate perioperative RNs about the methods for effective management of hemostasis during surgery to promote positive outcomes for the surgical patient.
Objectives
After completion of this continuing nursing education activity, the participant will be able to:
1. Identify the clinical implications of surgical bleeding.
2. Differentiate between mechanical, energy-based, and chemical methods of surgical hemostasis.
3. Compare the various categories of topical hemostatic products.
4. Identify key factors to consider in the selection of hemostatic products.
5. Describe perioperative nursing care for patients undergoing surgical hemostasis.
2.4 Contact Hours are available through AORN. Learn more at http://bit.ly/HemostasisStudyGuide. This education program was funded through the AORN Foundation by a grant from Ethicon Biosurgery.Shock - Pathophysiology, Clinical Features & Management
1. Hemorrhagic shock is the most common cause of shock in surgical or trauma patients and results from blood loss that exceeds 15% of circulating volume.
2. Initial management of hemorrhagic shock involves identifying the source of bleeding, providing immediate resuscitation with fluids and blood products, and controlling hemorrhage.
3. Damage control resuscitation principles are followed, including permissive hypotension to limit blood loss and balanced use of crystalloids, colloids, platelets, and plasma to prevent coagulopathy.
Haemosthesis in surgery
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This document discusses guidelines for transfusion therapy and management of postoperative bleeding in cardiac surgery patients. It provides an overview of factors that can influence bleeding, complications of blood transfusions, and tests to assess coagulation status. The document outlines guidelines for transfusion of blood products like platelets, plasma, cryoprecipitate based on results of coagulation tests or thromboelastography. It also provides guidelines for surgical re-exploration based on chest tube output. Management of massive bleeding and tamponade is discussed.
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02a Surgical hemostasis
This document discusses hemostasis in surgical patients. It begins by defining hemostasis as the state of fluid equilibrium within blood vessels. It then describes the two mechanisms of hemostasis - primary hemostasis involving vasoconstriction and platelet plug formation, and secondary hemostasis involving activation of the coagulation cascade and formation of a fibrin clot. The document outlines the coagulation cascade and its natural inhibitors. It discusses various defects of hemostasis, preoperative screening tests for bleeding risk, and strategies to achieve surgical hemostasis including direct pressure, cauterization, packing, topical hemostats, and fibrin glue.
Haemostasis in surgery
Surgical hemostasis is one of the pillars of modern surgery. Adequate hemostasis in a surgical patient involves a detailed perioperative clinical evaluation and investigation, and various intra operative techniques and options. Ensuring adequate surgical hemostasis reduces morbidity and mortality by modulating the metabolic response to trauma, decreasing the incidence of post operative anemia, reduces rates of surgical site infection and ultimately improving wound healing
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This document discusses perioperative bleeding and homeostasis. It begins with defining bleeding and describing different types. It then covers preoperative bleeding risk assessment, including medication and bleeding history, physical exam, and tools to evaluate risk. Methods of achieving homeostasis during and after surgery are outlined, including mechanical, thermal, pharmacological, and TEG monitoring. Predictors of postoperative bleeding in cardiac surgery and guidelines for assessing bleeding risk from British and European societies are presented.
Management of Surgical Hemostasis: An Independent Study Guide
Management of Surgical Hemostasis: An Independent Study GuideAssociation of periOperative Registered Nurses (AORN)
Effective management of hemostasis during surgery is critical for the patient. Using the nursing process and evidence-based practices, this independent study program will assist the perioperative RN identify risks, benefits, indications, contraindications, and adverse effects for the various methods available for control of bleeding during surgery. The goal of this learning activity is to educate perioperative RNs about the methods for effective management of hemostasis during surgery to promote positive outcomes for the surgical patient.
Objectives
After completion of this continuing nursing education activity, the participant will be able to:
1. Identify the clinical implications of surgical bleeding.
2. Differentiate between mechanical, energy-based, and chemical methods of surgical hemostasis.
3. Compare the various categories of topical hemostatic products.
4. Identify key factors to consider in the selection of hemostatic products.
5. Describe perioperative nursing care for patients undergoing surgical hemostasis.
2.4 Contact Hours are available through AORN. Learn more at http://bit.ly/HemostasisStudyGuide. This education program was funded through the AORN Foundation by a grant from Ethicon Biosurgery.Shock - Pathophysiology, Clinical Features & Management
1. Hemorrhagic shock is the most common cause of shock in surgical or trauma patients and results from blood loss that exceeds 15% of circulating volume.
2. Initial management of hemorrhagic shock involves identifying the source of bleeding, providing immediate resuscitation with fluids and blood products, and controlling hemorrhage.
3. Damage control resuscitation principles are followed, including permissive hypotension to limit blood loss and balanced use of crystalloids, colloids, platelets, and plasma to prevent coagulopathy.
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Dr Kabiru SALISU
kbmed2003@yahoo.com
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This document discusses guidelines for transfusion therapy and management of postoperative bleeding in cardiac surgery patients. It provides an overview of factors that can influence bleeding, complications of blood transfusions, and tests to assess coagulation status. The document outlines guidelines for transfusion of blood products like platelets, plasma, cryoprecipitate based on results of coagulation tests or thromboelastography. It also provides guidelines for surgical re-exploration based on chest tube output. Management of massive bleeding and tamponade is discussed.
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This document discusses hemorrhage and shock. It covers:
1. The classification of hemorrhage based on the vessel involved, timing, volume lost, and type of intervention needed.
2. The signs and symptoms of hemorrhage and its pathophysiological effects like depletion of venous reservoirs and failure to maintain blood pressure.
3. The physiological response to hemorrhage including hemostasis, the three stages of clot formation, and new models of hemostasis involving an initiation, amplification, and propagation phase.
4. Methods for measuring blood loss are also mentioned. The document provides an overview of hemorrhage, its effects, and the body's response to stop bleeding.
Hemostasis
The document discusses several hemostasis problems commonly seen in critical illness, including critical illness coagulopathies, uncontrolled bleeding and massive transfusion, anticoagulation-associated problems, and case scenarios. It provides details on acquired hypocoagulable states, the coagulation cascade, disseminated intravascular coagulation, sepsis-associated coagulopathy, heparin-induced thrombocytopenia, immune thrombocytopenic purpura, and pregnancy-related thrombocytopenias. Treatment involves addressing the underlying cause, transfusing blood products, and considering anticoagulants or direct thrombin inhibitors depending on the clinical situation.
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The document discusses systemic inflammatory response syndrome (SIRS) and defines it as a systemic response to various stresses that includes symptoms like fever, increased heart rate, respiratory rate and white blood cell count. It outlines the progression from infection to bacteremia to sepsis, which involves SIRS criteria and a suspected or proven infection. The stages of sepsis like severe sepsis, septic shock and refractory septic shock are defined based on the presence of organ dysfunction or hypotension.
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This document summarizes a seminar on bleeding disorders. It begins with an introduction to hemostasis and the coagulation cascade. It describes the roles of platelets, coagulation factors, and the intrinsic and extrinsic pathways. It discusses specific coagulation factor deficiencies like hemophilia A, hemophilia B, and von Willebrand disease. The document outlines approaches to evaluating patients for bleeding disorders, including history, physical exam, and laboratory tests like complete blood count, bleeding time, prothrombin time, and factor assays. Overall, the seminar provides a comprehensive overview of hemostasis and classification of bleeding disorders.
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This document provides information on disseminated intravascular coagulation (DIC), including its pathophysiology, causes, clinical manifestations, diagnosis, and treatment. DIC is characterized by excessive activation of coagulation leading to microvascular thrombosis. It is not a primary disease but can arise from various clinical conditions. Common causes in infants and children include sepsis, trauma, and malignancies. The pathophysiology involves tissue damage and inflammation that activates coagulation. Diagnosis is based on laboratory tests showing consumption of platelets and coagulation factors. Treatment focuses on treating the underlying condition, replacing coagulation factors if bleeding is present, and administering anticoagulants if thrombosis occurs.
16 complication of blood t.ppt last
Red blood cells carry oxygen, white blood cells fight infection, and platelets help with clotting. Plasma contains nutrients, hormones, and clotting factors. Blood type is determined by genes and impacts compatibility for transfusions. The right blood must be given to the right patient at the right time to avoid complications like allergic reactions, febrile reactions, and hemolytic transfusion reactions which can be fatal if not addressed promptly. Proper protocols and documentation are essential for safe blood transfusions.
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This document provides information about platelet transfusion. It discusses what platelets are, their role in hemostasis, normal platelet counts, causes of thrombocytopenia, indications for platelet transfusion, contraindications, donor criteria, preparation of platelet concentrates, dosing, response to transfusion, complications including immunological and non-immunological issues, and methods to reduce complications like use of leukoreduced products. The document contains detailed information about platelet immunology, causes of refractoriness, its management, and methods to improve safety and availability of platelet transfusion like use of matched donors and crossmatching.
Trauma resuscitation
1) The document discusses a case of a pedestrian hit by a car with injuries including a flail chest, unstable pelvis, and internal bleeding. The goals of treatment are to prevent death from hemorrhage through early intervention, good airway management, resuscitation, and surgical intervention.
2) It introduces the principles of damage control resuscitation (DCR) including permissive hypotension to limit blood loss, early use of blood products to replace lost volume and clotting factors, and damage control surgery to control bleeding. DCR aims to address the "lethal triad" of coagulopathy, acidosis, and hypothermia.
3) Clinical markers like thromboelastography
Coagulation Disorders
This document discusses coagulation disorders and bleeding disorders. It describes the normal hemostatic mechanisms including the vascular, platelet and coagulation systems. Bleeding disorders can cause spontaneous or excessive bleeding and can be due to increased vascular fragility, platelet deficiencies or dysfunctions, or derangements of clotting factors. Specific disorders discussed include hemophilia A/B, von Willebrand's disease, and disseminated intravascular coagulation. Laboratory tests that can identify coagulation disorders include the tourniquet test, bleeding time, clotting time, platelet count, clot retraction time, prothrombin time, activated partial thromboplastin time, and thrombin time. Further specific tests may
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This document discusses a clinical case of acquired bleeding disorder in a 74-year-old man presenting with bruising. Testing revealed von Willebrand disease type 2 and angiodysplasias. The key considerations for this patient include potential medication and liver disease contributions to bleeding, as well as the diagnosis of acquired von Willebrand disease. Treatment focuses on managing the underlying cause of the acquired bleeding disorder.
Coagulopathy
This document discusses coagulopathy, which refers to medical disorders involving abnormal blood clotting due to deficiencies or issues with platelets, clotting factors, or the fibrinolytic system. It defines various bleeding disorders and coagulation tests. Specific conditions covered include immune thrombocytopenic purpura (ITP), von Willebrand disease, hemophilia A/B, and disseminated intravascular coagulation (DIC). Treatment involves replacing the deficient clotting factor, managing underlying causes, or administering medications depending on the condition causing the coagulopathy. Complications can include excessive bleeding, joint damage, and transmission of infections.
Perioperative Management of the patient with hematologic disorders
This document discusses perioperative management of patients with hematologic disorders. It begins by explaining the importance of hemostasis, or the body's ability to control bleeding, during wound healing after surgery. It then provides details on the classic model of coagulation, involving the vascular, platelet, coagulation, and fibrinolytic phases. A newer cell-based model of coagulation involving initiation, amplification and propagation phases is also described. Key screening laboratory tests for identifying hemostatic abnormalities are outlined.
Complications of blood transfusion
The document discusses several potential complications of blood transfusion:
1) The most common complications are febrile nonhemolytic and chill-rigor reactions. The most serious complications are acute hemolytic reactions and transfusion-related acute lung injury, which have high mortality rates.
2) If any symptoms of a transfusion reaction occur, such as chills, fever, or breathing problems, the transfusion must be stopped immediately and investigated.
3) Delayed hemolytic reactions can occur 1-4 weeks after transfusion if a patient has low antibody levels not detected on pretransfusion tests.
Preoperative investigations and significance.
This document summarizes the importance of preoperative investigations and assessments. It outlines key tests that should be performed for major surgeries, such as complete blood count, serum creatinine, ECG, coagulation screening, and chest x-rays. Additional tests like blood glucose, liver function tests, and arterial blood gases are recommended for patients with certain medical conditions. The results of preoperative investigations help optimize patient health prior to surgery and identify risks. A thorough preoperative evaluation is essential to reduce preventable complications.
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This document discusses bleeding and clotting disorders, including the diagnosis and evaluation of bleeding problems. It describes the principal presentations of bleeding disorders such as easy bruising, bleeding from mucous membranes, and excessive bleeding after trauma. It then covers specific types of bleeding disorders like those affecting platelets or coagulation factors. The document outlines typical screening tests used to evaluate bleeding disorders and describes both inherited and acquired causes of platelet and coagulation abnormalities.
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This document discusses different methods for intraoperative blood conservation. It describes three main types of autologous blood transfusion: preoperative autologous donation, acute normovolumic hemodilution, and intraoperative cell salvage. Intraoperative cell salvage involves collecting blood lost during surgery, washing and separating red blood cells, and reinfusing them to the patient. The document outlines the detailed cell salvage process and different devices used, including cell processors that centrifuge and wash blood and ultrafiltration devices that filter whole blood. It notes advantages and considerations for each method of autologous blood transfusion.
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The document discusses blood transfusion, including indications for different blood components, blood donation and collection processes, effects of blood storage, and administration of blood transfusions. It covers donor selection criteria, methods of collection to ensure sterility, changes that occur to blood components over time in storage, and steps to properly administer transfusions including patient investigation and cross-matching. Potential complications of transfusion are also summarized, including immediate reactions like febrile responses and allergic reactions, as well as delayed issues such as thrombophlebitis.
Blood transfusion in surgery
The document provides an overview of blood transfusion, including donor selection, blood components and their indications, pre-transfusion handling, administration principles, massive transfusion, autologous transfusion, complications and their management, and blood substitutes. Donor selection involves medical history screening and health assessments. Key blood components discussed are packed red blood cells, platelet concentrates, fresh frozen plasma, and cryoprecipitate. Proper storage, grouping, compatibility testing and administration procedures are outlined to ensure safety. Complications can be immediate or delayed, including infections transmitted and reactions to plasma proteins. Blood substitutes under development aim to replace functions of plasma, red cells and platelets.
surgical haemostasis olofin.pptx
The document discusses surgical haemostasis, which is the process of preventing or stopping blood loss from injured blood vessels during or after surgery. It defines haemostasis and outlines its importance in surgery. The physiology of haemostasis is described, involving vasoconstriction, platelet plug formation, and coagulation/fibrin formation. Causes of bleeding during or after surgery are discussed, including defects in haemostasis or platelet function. Methods of achieving haemostasis are covered, such as mechanical techniques like pressure, sutures, and cauterization, as well as chemical agents, blood products, and thermal techniques. Management of haemostasis in the pre-operative, intra-operative, and post-operative periods
COAGULATION FACTORS AND DENTAL PROCEDURES
Coagulation factors are proteins in the blood that work together to help form blood clots. Some coagulation factor deficiencies can cause bleeding disorders like hemophilia. For dental procedures in patients with coagulation issues, replacement of deficient factors or use of antifibrinolytic drugs is often needed before, during, and after treatment to reduce bleeding risks. Local anesthetic techniques that minimize trauma are preferred. Proper factor level monitoring and hemostatic support tailored to the specific condition can allow for many routine dental treatments to be completed safely.
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This document discusses hemorrhage and shock. It covers:
1. The classification of hemorrhage based on the vessel involved, timing, volume lost, and type of intervention needed.
2. The signs and symptoms of hemorrhage and its pathophysiological effects like depletion of venous reservoirs and failure to maintain blood pressure.
3. The physiological response to hemorrhage including hemostasis, the three stages of clot formation, and new models of hemostasis involving an initiation, amplification, and propagation phase.
4. Methods for measuring blood loss are also mentioned. The document provides an overview of hemorrhage, its effects, and the body's response to stop bleeding.
Hemostasis
The document discusses several hemostasis problems commonly seen in critical illness, including critical illness coagulopathies, uncontrolled bleeding and massive transfusion, anticoagulation-associated problems, and case scenarios. It provides details on acquired hypocoagulable states, the coagulation cascade, disseminated intravascular coagulation, sepsis-associated coagulopathy, heparin-induced thrombocytopenia, immune thrombocytopenic purpura, and pregnancy-related thrombocytopenias. Treatment involves addressing the underlying cause, transfusing blood products, and considering anticoagulants or direct thrombin inhibitors depending on the clinical situation.
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The document discusses systemic inflammatory response syndrome (SIRS) and defines it as a systemic response to various stresses that includes symptoms like fever, increased heart rate, respiratory rate and white blood cell count. It outlines the progression from infection to bacteremia to sepsis, which involves SIRS criteria and a suspected or proven infection. The stages of sepsis like severe sepsis, septic shock and refractory septic shock are defined based on the presence of organ dysfunction or hypotension.
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16 complication of blood t.ppt last
Red blood cells carry oxygen, white blood cells fight infection, and platelets help with clotting. Plasma contains nutrients, hormones, and clotting factors. Blood type is determined by genes and impacts compatibility for transfusions. The right blood must be given to the right patient at the right time to avoid complications like allergic reactions, febrile reactions, and hemolytic transfusion reactions which can be fatal if not addressed promptly. Proper protocols and documentation are essential for safe blood transfusions.
Thromboelastography
The document discusses thromboelastography (TEG), a technique for assessing whole blood coagulation. TEG monitors the viscoelastic properties of clotting blood to evaluate clot formation, kinetics, strength and stability. It provides a global assessment of hemostasis and can detect coagulation factor deficiencies, platelet issues and fibrinolysis. TEG results are rapid and help guide treatment, unlike conventional coagulation tests which examine isolated parts of the clotting process. Measurements from a TEG tracing include r and k times, alpha angle, maximum amplitude and lysis parameters. TEG gives useful qualitative and quantitative analysis of hemostasis.
Damage Control Resuscitation
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Trauma resuscitation
1) The document discusses a case of a pedestrian hit by a car with injuries including a flail chest, unstable pelvis, and internal bleeding. The goals of treatment are to prevent death from hemorrhage through early intervention, good airway management, resuscitation, and surgical intervention.
2) It introduces the principles of damage control resuscitation (DCR) including permissive hypotension to limit blood loss, early use of blood products to replace lost volume and clotting factors, and damage control surgery to control bleeding. DCR aims to address the "lethal triad" of coagulopathy, acidosis, and hypothermia.
3) Clinical markers like thromboelastography
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This document discusses coagulation disorders and bleeding disorders. It describes the normal hemostatic mechanisms including the vascular, platelet and coagulation systems. Bleeding disorders can cause spontaneous or excessive bleeding and can be due to increased vascular fragility, platelet deficiencies or dysfunctions, or derangements of clotting factors. Specific disorders discussed include hemophilia A/B, von Willebrand's disease, and disseminated intravascular coagulation. Laboratory tests that can identify coagulation disorders include the tourniquet test, bleeding time, clotting time, platelet count, clot retraction time, prothrombin time, activated partial thromboplastin time, and thrombin time. Further specific tests may
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This document discusses coagulopathy, which refers to medical disorders involving abnormal blood clotting due to deficiencies or issues with platelets, clotting factors, or the fibrinolytic system. It defines various bleeding disorders and coagulation tests. Specific conditions covered include immune thrombocytopenic purpura (ITP), von Willebrand disease, hemophilia A/B, and disseminated intravascular coagulation (DIC). Treatment involves replacing the deficient clotting factor, managing underlying causes, or administering medications depending on the condition causing the coagulopathy. Complications can include excessive bleeding, joint damage, and transmission of infections.
Perioperative Management of the patient with hematologic disorders
This document discusses perioperative management of patients with hematologic disorders. It begins by explaining the importance of hemostasis, or the body's ability to control bleeding, during wound healing after surgery. It then provides details on the classic model of coagulation, involving the vascular, platelet, coagulation, and fibrinolytic phases. A newer cell-based model of coagulation involving initiation, amplification and propagation phases is also described. Key screening laboratory tests for identifying hemostatic abnormalities are outlined.
Complications of blood transfusion
The document discusses several potential complications of blood transfusion:
1) The most common complications are febrile nonhemolytic and chill-rigor reactions. The most serious complications are acute hemolytic reactions and transfusion-related acute lung injury, which have high mortality rates.
2) If any symptoms of a transfusion reaction occur, such as chills, fever, or breathing problems, the transfusion must be stopped immediately and investigated.
3) Delayed hemolytic reactions can occur 1-4 weeks after transfusion if a patient has low antibody levels not detected on pretransfusion tests.
Preoperative investigations and significance.
This document summarizes the importance of preoperative investigations and assessments. It outlines key tests that should be performed for major surgeries, such as complete blood count, serum creatinine, ECG, coagulation screening, and chest x-rays. Additional tests like blood glucose, liver function tests, and arterial blood gases are recommended for patients with certain medical conditions. The results of preoperative investigations help optimize patient health prior to surgery and identify risks. A thorough preoperative evaluation is essential to reduce preventable complications.
Bleeding and clotting disorders dr anoop k r
This document discusses bleeding and clotting disorders, including the diagnosis and evaluation of bleeding problems. It describes the principal presentations of bleeding disorders such as easy bruising, bleeding from mucous membranes, and excessive bleeding after trauma. It then covers specific types of bleeding disorders like those affecting platelets or coagulation factors. The document outlines typical screening tests used to evaluate bleeding disorders and describes both inherited and acquired causes of platelet and coagulation abnormalities.
Intra operative blood_conservation
This document discusses different methods for intraoperative blood conservation. It describes three main types of autologous blood transfusion: preoperative autologous donation, acute normovolumic hemodilution, and intraoperative cell salvage. Intraoperative cell salvage involves collecting blood lost during surgery, washing and separating red blood cells, and reinfusing them to the patient. The document outlines the detailed cell salvage process and different devices used, including cell processors that centrifuge and wash blood and ultrafiltration devices that filter whole blood. It notes advantages and considerations for each method of autologous blood transfusion.
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The document discusses blood transfusion, including indications for different blood components, blood donation and collection processes, effects of blood storage, and administration of blood transfusions. It covers donor selection criteria, methods of collection to ensure sterility, changes that occur to blood components over time in storage, and steps to properly administer transfusions including patient investigation and cross-matching. Potential complications of transfusion are also summarized, including immediate reactions like febrile responses and allergic reactions, as well as delayed issues such as thrombophlebitis.
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The document provides an overview of blood transfusion, including donor selection, blood components and their indications, pre-transfusion handling, administration principles, massive transfusion, autologous transfusion, complications and their management, and blood substitutes. Donor selection involves medical history screening and health assessments. Key blood components discussed are packed red blood cells, platelet concentrates, fresh frozen plasma, and cryoprecipitate. Proper storage, grouping, compatibility testing and administration procedures are outlined to ensure safety. Complications can be immediate or delayed, including infections transmitted and reactions to plasma proteins. Blood substitutes under development aim to replace functions of plasma, red cells and platelets.
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surgical haemostasis olofin.pptx
The document discusses surgical haemostasis, which is the process of preventing or stopping blood loss from injured blood vessels during or after surgery. It defines haemostasis and outlines its importance in surgery. The physiology of haemostasis is described, involving vasoconstriction, platelet plug formation, and coagulation/fibrin formation. Causes of bleeding during or after surgery are discussed, including defects in haemostasis or platelet function. Methods of achieving haemostasis are covered, such as mechanical techniques like pressure, sutures, and cauterization, as well as chemical agents, blood products, and thermal techniques. Management of haemostasis in the pre-operative, intra-operative, and post-operative periods
COAGULATION FACTORS AND DENTAL PROCEDURES
Coagulation factors are proteins in the blood that work together to help form blood clots. Some coagulation factor deficiencies can cause bleeding disorders like hemophilia. For dental procedures in patients with coagulation issues, replacement of deficient factors or use of antifibrinolytic drugs is often needed before, during, and after treatment to reduce bleeding risks. Local anesthetic techniques that minimize trauma are preferred. Proper factor level monitoring and hemostatic support tailored to the specific condition can allow for many routine dental treatments to be completed safely.
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The normal clotting process involves platelets and coagulation factors working together to form a clot and stop bleeding. Platelets initially aggregate at the site of injury and release substances to enhance clotting. Coagulation factors are then activated through initiation and amplification pathways, leading to thrombin generation and fibrin strand formation to stabilize the clot. Bleeding disorders can occur if there are deficiencies or dysfunctions of platelets, coagulation factors, or excessive fibrinolysis. Laboratory tests including platelet count, bleeding time, prothrombin time, activated partial thromboplastin time, and thrombin time are used to evaluate the hemostatic system and identify the cause of bleeding disorders.
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This document discusses disseminated intravascular coagulation (DIC), including:
1. It defines DIC as a condition where blood clots form throughout the small blood vessels, reducing blood flow and damaging organs. It involves activation of both clotting and fibrinolytic systems due to widespread endothelial damage.
2. Risk factors for DIC include sepsis, trauma, obstetric complications like abruptio placentae, malignancy, and liver or renal failure. Complications can include organ dysfunction, thrombosis, and life-threatening hemorrhage.
3. Investigations show decreased platelet count, fibrinogen, and increased PT, PTT, D-dimer. Peripheral smear shows sch
Hemophilia
Hemophilia is a genetic bleeding disorder caused by deficiencies in clotting factors VIII or IX. The main symptoms are prolonged bleeding after injury or surgery and bleeding into joints or muscles. There are three main types - A, B, and C - defined by which clotting factor is deficient. Treatment involves replacing the missing clotting factor through infusions of plasma-derived or recombinant factor concentrates. Management also focuses on preventing bleeding episodes and complications through measures like RICE, immobilization, exercise, and infection control.
thrombosis
This document discusses blood coagulation and thrombosis. It begins by defining coagulation as the process by which blood loses fluidity and becomes a jelly-like clot. It then describes the stages of clotting including formation of prothrombin activator, conversion of prothrombin to thrombin, and conversion of fibrinogen to fibrin. The coagulation cascade and factors involved are also outlined. The document further discusses thrombosis, its causes including endothelial injury, alterations in blood flow, and hypercoagulability. Common sites of arterial and venous thrombi are compared. Oral health considerations and dental management of patients with bleeding disorders are summarized.
Hemophilia
1) Hemophilia is a bleeding disorder caused by deficiencies in clotting factors VIII or IX, resulting in prolonged bleeding from minor injuries or surgery.
2) There are two main types - type A from a factor VIII deficiency is most common, type B from a factor IX deficiency is called Christmas disease.
3) Treatment involves replacing the missing clotting factor, though some may develop inhibitors requiring additional therapies like immunosuppression. Nursing focuses on education, prevention of injury, and management of bleeding episodes.
clinical approach to patients with bleeding tendency
this presentation explains the physiology of hemostasis, in addition to the clinical approach for patients presenting with bleeding tendency.
Bloodcoagulation AND USE IN DENTAL MANAGEMENT
This document summarizes blood coagulation and disorders of coagulation. It begins with an overview of hemostasis, which involves four main steps: 1) vascular spasm, 2) platelet plug formation, 3) formation of a platelet plug, and 4) blood coagulation. It then describes platelet plug formation and the blood coagulation cascade, known as the secondary hemostasis. This involves a cascade of reactions by clotting factors that activates inactive enzymes until thrombin converts fibrinogen to fibrin. The document discusses the intrinsic and extrinsic pathways of blood coagulation and lists investigations of hemostatic function. It also summarizes several disorders of coagulation like hemophilia A/B/C and von Willebrand
anurag .pptx (1) - 20240118_091649.pdf very useful
This is very useful for mbbs students by which they can learn about homeostasis
Bleeding and clotting disorders in children
This document provides information on bleeding and coagulation disorders in children. It begins with definitions of bleeding disorders and then describes the phases of hemostasis. It discusses the etiology of bleeding disorders including vessel wall abnormalities like Ehlers-Danlos syndrome, platelet disorders like idiopathic thrombocytopenic purpura, and coagulation disorders such as hemophilia A. It provides details on specific disorders, their causes, clinical features, lab findings, and treatment options. The document concludes with approaches to evaluating a child presenting with a bleeding disorder.
Blood coagulation
This presentation will help you to understand the physiology of blood coagulation and various factors involved in it.
Mechanism of blood clotting and blood dyscrasias
This seminar includes hemostasis,mechanism of blood clotting and associated blood dyscrasias commonly seen in children and their treatments with a note on antifibrinolytics
blood coagulation.pptx
Blood coagulation is a complex process involving multiple coagulation factors that work together in a cascade to ultimately convert fibrinogen into fibrin to form a blood clot. There are two pathways (intrinsic and extrinsic) that lead to the formation of thrombin, which then converts fibrinogen into fibrin. Some bleeding disorders result from deficiencies in specific coagulation factors, such as Hemophilia A and B due to Factor VIII and IX deficiencies. Von Willebrand disease is caused by a defect in von Willebrand factor which is involved in platelet function. Coagulation tests evaluate different parts of the coagulation cascade to identify deficiencies.
Coagulation failure in pregnancy
This document discusses alterations in coagulation and fibrinolysis during pregnancy. It covers the normal coagulation cascade and triggers, as well as classifications of coagulation failure in pregnancy. Specific conditions covered include disseminated intravascular coagulation (DIC), thrombocytopenic coagulopathies, anticoagulant therapy, and von Willebrand disease. Diagnosis and management of DIC and thrombocytopenia are outlined. The importance of promptly diagnosing and treating coagulation disorders to prevent maternal morbidity and mortality is emphasized.
presentation_bleeding_and_clotting_disorder__1496298530_281895.pptx
- Bleeding and clotting disorders can impact dental treatment and must be properly evaluated. They are classified as vessel wall disorders (like scurvy), platelet disorders (like thrombocytopenia), or clotting disorders (like hemophilia A).
- Identification involves patient history of unusual bleeding. Conditions are managed by treating the underlying cause, replacing lost blood or clotting factors, and controlling bleeding episodes. Prognosis depends on appropriate diagnosis and management to prevent acute bleeding.
Hemostasis and coagulation of blood by Pandian M, Tutor, Dept of Physiology, ...
DEFINITION Hemostasis
STAGES OF HEMOSTASIS
VASOCONSTRICTION
PLATELET PLUG FORMATION
COAGULATION OF BLOOD DEFINITION
FACTORS INVOLVED IN BLOOD CLOTTING
SEQUENCE OF CLOTTING MECHANISM
BLOOD CLOT
ANTICLOTTING MECHANISM IN THE BODY
ANTICOAGULANTS
PHYSICAL METHODS TO PREVENT BLOOD CLOTTING
PROCOAGULANTS
TESTS FOR BLOOD CLOTTING
APPLIED PHYSIOLOGY
Similar to 6 surgical hemostasis (20)
clinical approach to patients with bleeding tendency
clinical approach to patients with bleeding tendency
anurag .pptx (1) - 20240118_091649.pdf very useful
anurag .pptx (1) - 20240118_091649.pdf very useful
presentation_bleeding_and_clotting_disorder__1496298530_281895.pptx
presentation_bleeding_and_clotting_disorder__1496298530_281895.pptx
Hemostasis and coagulation of blood by Pandian M, Tutor, Dept of Physiology, ...
Hemostasis and coagulation of blood by Pandian M, Tutor, Dept of Physiology, ...
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2. Thoroughly removing infected carious lesions while differentiating between infected and stained dentin.
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3 shock
1) The patient, a 28-year-old female, was involved in a motor vehicle collision where she was unrestrained. She presents with tachycardia, hypotension, confusion and anxiety consistent with shock.
2) Shock is a clinical syndrome characterized by organ dysfunction due to inadequate tissue perfusion and hypotension. Prolonged hypotension can lead to organ failure and death if not treated.
3) Based on the mechanism, this patient's shock is likely hypovolemic from blood loss due to her injuries sustained in the motor vehicle collision as an unrestrained passenger. Treatment involves fluid resuscitation and controlling any active bleeding.
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6 surgical hemostasis
- 1. SURGICAL HEMOSTASIS Prof. Faisal Ghani Siddiqui MBBS; FCPS; PGDIP-BIOETHICS; MCPS-HPE
- 2. LEARNING OUTCOMES By the end of this lecture, the students will learn; • What is hemostasis and why blood doesn't clot inside intact blood vessels • What are different causes of excessive bleeding during or after surgery • How to evaluate your patient for hemostasis before surgery?
- 3. HEMOSTASIS
- 4. Will this bleeding stop?
- 5. HEMOSTASIS arrest of the escape of blood by either; • natural means (vessel spasm or clot formation),or • artificial means (compression or ligation)
- 6. NATURAL HEMOSTASIS Local vasoconstriction Formation of platelet plug Formation of blood clot
- 7. 12 CLOTTING FACTORS NAME VIII Antihaemophilic factor A IX Antihaemophilic factor B (Christmas factor) X Staurt-Power factor XI Antihaemophilic factor C XII Hagemen factor XIII Fibrin stabilizing factor NAME I Fibrinogen II Prothrombin III Tissue thromboplastin IV Calcium V Proaccelerin (Labile factor) VII Proconvertin (Stable factor)
- 8. CLOTTING CASCADE INTRINSIC PATHWAY • All factors needed are present in the blood • Triggered when ‘contact factors’ are exposed to collagen or basement membrane at the site of injury EXTRINSIC PATHWAY • Requires tissue thromboplastin to be released from damaged cells (outside blood)
- 11. SO WHY DOESN'T’ THE BLOOD CLOT INSIDE INTACT BLOOD VESSELS?
- 12. NATURAL INHIBITORS OF COAGULATION CASCADE • Smoothness of the endothelium • Continuous blood flow • Prostacyclin (secreted by the platelets) • Heparin (secreted by the mast cells) • Antithrombin III (secreted by the liver) • Protein C & S (natural anticoagulants)
- 13. CAUSES OF BLEEDING DURING OR AFTER SURGERY
- 14. CAUSES OF BLEEDING DURING OR AFTER SURGERY • Poor control during surgery • Defects of hemostasis
- 15. DEFECTS OF HEMOSTASIS • Congenital • Acquired
- 16. CONGENITAL DEFECTS OF HEMOSTASIS • Hemophilia A (factor VIII deficiency) • Hemophilia B (factor IX deficiency)
- 17. ACQUIRED DEFECTS OF HEMOSTASIS • Liver diseases • Vitamin K deficiency • Disseminated intravascular coagulation • Anticoagulants • Massive blood transfusion • Platelet disorders
- 19. HISTORY • Easy bruising • Nose bleeds • Prolonged bleeding after cuts • Bleeding >3 mts. After brushing tooth • Prolonged/excessive menstrual cycles • Severe bleeding after tooth extraction / surgery
- 20. HISTORY • Liver disease, renal failure or hypersplenism • Family H/O hemophilia • Current or recent use of drugs that may interfere with hemostasis
- 21. EXAMINATION –CUTANEOUS SIGNS OF LIVER DISEASE JAUNDICE SPIDER NEVI
- 25. LAB TESTS FOR HEMOSTASIS • Bleeding time • Prothrombin time • Partial thromboplastin test • Platelet count • Bone marrow aspiration • Fibrinogen assay • Fibrin degradation product