it consist introduction of DIC, definition, etiology and causes, pathophysiology, diagnostic evaluation and its management. it consist of complication too. easy to understand with the help of pictures.

1. DISSEMINATED
INTRAVASCULAR
COAGULATION
Ms. Bharti Sharma
Nursing Tutor
BECON, Jammu.

2. INTRODUCTION

3. • DEFINITION:-
 Disseminated intravascular coagulation (DIC) is a
syndrome in which either the extrinsic or intrinsic or both
pathways are activated to produce multiple fibrin clots in
small blood vessels. The resultant reduction of the
coagulation factors and platelets results in bleeding.
 DIC is a serious bleeding and thrombotic disorder that
results from abnormally initiated and accelerated clotting.
Subsequently decreases in clotting factors and platelets
ensue, which may lead to uncontrolled hemorrhage.

5. ETIOLOGY
 ACUTE DIC :- Shock and its type
Hemolytic processes( mismatched transfusion,
immunological disorders)
Obstetric conditions (HELLP syndrome, abruptio
placenta, septic abortion)
Malignancies ( Acute leukemia, lymphoma, tumor lysis
syndrome)
Tissue damage( heatstroke, snakebite, severe head
injury, transplant rejection)

6.  SUBACUTE DIC :- Malignancy ( lymphoproliferative
malignancies, metastatic cancer)
• Obstetric ( retained dead fetus)

7.  CHRONIC DIC :- Liver disease
• Systemic lupus erythematous
• malignancy

8. PATHOPHYSIOLOGY

14. CLINICAL MANIFESTATIONS
1.Signs of abnormal clotting :-
a) Coolness and mottling of extremities.
b) Acrocyanosis (cold, mottled extremities with clear demarcation from
normal tissue).
c) Dyspnea, adventitious breath sound.
d) Altered mental status.
e) Acute renal failure.
f) Pain (e.g, related to bowel infarction).
.

15. 2.Signs of abnormal bleeding:-
a) 0ozing, bleeding from sites of procedures, IV catheter insertion sites,
suture lines, mucous membranes, orifices.
b) Internal bleeding leading to changes in vital organ function, altered
vital signs.

17. INVESTIGATION
 HISTORY COLLECTION
 PHYSICAL EXAMINATION
 ASSESSMENT OF SYMPTOMS
 COMPLETE BLOOD COUNT
 PERIPHERAL BLOOD SMEAR
 PROTHROMBIN TIME
 FIBRINOGEN LEVEL
 FIBRIN SPLIT PRODUCTS COUNT
 D- DIMER MARKER

18. MANAGEMENT
Management depends upon the severity of the
condition. A variety of methods are used to manage
DIC.
First, if chronic DIC is diagnosed in a patient who is not
bleeding , no therapy is needed for it. Treatment for
underlying disease may be sufficient to reverse the DIC.
Second, when the patient with DIC is bleeding, therapy
is directed towards providing support with necessary
blood products while treating the primary disorder.

19. BLOOD TRANSFUSSION THERAPY
 The blood products are administered cautiously based on specific
components deficiencies to patients who have serious bleeding, are at
a high risk of bleeding or requires invasive procedures.
 In general, platelets are given to correct thrombocytopenia if the
platelet count is less than 20000 /meu ltr. Or less than 50000/ meu ltr.
with bleeding.
 Cryoprecipitate replaces factor VIII and fibrinogen and is given if the
fibrinogen level is below 100mg/dl .
 Fresh frozen plasma replaces all clotting factors except platelets and
provides a source of antithrombin.
 Patient with thrombosis is treated by heparin or low –molecular-weight
heparin.

20. NURSING MANAGEMENT
 Assessment
 Nursing diagnosis
 Goal
 Nursing intervention
 Evaluation

21. SUMMARY