Disseminated Intravascular

Coagulation (DIC)
Alyssa Cardinal

Dont
let
the
name
fool
you.

The term disseminated

intravascular coagulation can
be misleading because it
suggests the blood is clotting.
This is not necessarily the case.

DIC is a massive activation of

the coagulation system leading to
systemic clot formation and
emboli.
Consumption of clotting factors
faster than synthesis leads to
systemic BLEEDING!

So, what is it?

Etiology
DIC is:
not a disease
an abnormal

response of the
normal clotting
cascade stimulated
by a disease
process or disorder

DIC can:
occur as an acute,

subacute, or
chronic condition

Clinical Manifestations

Bleeding manifestations:

Pallor, petechiae, purpura, oozing blood,

venipuncture site bleeding, hematomas, and occult
hemorrhage

Respiratory manifestations:

Cardiovascular manifestations:

Tachypnea, hemoptysis, and orthopnea

Tachycardia, hypotension

GI manifestations:

Upper and lower GI bleeding, abdominal distention,

and bloody stools

Urinary manifestations:

Hematuria

Neurological manifestations

Vision changes, dizziness, headache, changes in mental

status, and irritability

Musculoskeletal manifestations

Bone and joint pain

Diagnostic Studies
clotting breakdown of fibrin and fibrinogen fibrin split products (FSPs)

FSPs interfere with blood coagulation

D-dimer is a specific marker for the degree of fibrinolysis.

Fragmented erythrocytes (schistocytes) may be found on

blood smears.

Tests that measure raw materials needed for coagulation

(e.g., platelets, fibrinogen) are reduced, and values that
measure times to clot (e.g., PT, PTT) are prolonged.

LABS

Collaborative Care

Diagnose quickly

Stabilize if needed (O2, volume replacement)

Treat the underlying cause

Control the ongoing thrombosis and bleeding

Apply pressure to leaking IV/central line/arterial line sites

Administer PLATELETS to correct thrombocytopenia if

Platelet count is < 20,000 or <50,000 with bleeding

Administer CRYOPRECIPITATE to replace factor VIII and

fibrinogen if the fibrinogen level is < 100 mg/dL

FRESH FROZEN PLASMA replaces all clotting factors except

platelets and provides a source of antithrombin

HEPARIN therapy is used to treat thrombosis, ONLY when the

benefit (reduce clotting) outweighs the risk (further bleeding)

Chronic DIC does not respond to oral anticoagulants, but it can

be controlled with long-term use of HEPARIN

Nursing Diagnoses
Ineffective peripheral tissue perfusion related to

bleeding and sluggish or diminished blood flow

secondary to thrombosis

Acute pain related to bleeding into tissues and

diagnostic procedures

Decreased cardiac output related to fluid volume

deficit

Anxiety related to fear of the unknown, disease

process, diagnostic procedures, and therapy

QUIZ
1. Which of the following is true in relation to DIC? (select the

best answer)
a. DIC exhibits widespread clotting in capillaries.
b. DIC results in systemic bleeding
c. The consumption of clotting factors leads to hemorrhage
d. A and B only
e. All of the above

QUIZ
1. Which of the following is true in relation to DIC? (select

the best answer)

a. DIC exhibits widespread clotting in capillaries.
b. DIC results in systemic bleeding
c. The consumption of clotting factors leads to hemorrhage
d. A and B only
e. All of the above

QUIZ
1. Which of the following are primary causes of DIC? (select

all that apply)

a.
b.
c.
d.
e.
f.
g.
h.
i.
j.

Shock
Septicemia
Mismatched blood transfusions
Abruptio placentae
Cancer
Fat and pulmonary emboli
Acute anoxia
Burns
Snakebites
Systemic lupus erythematosus

QUIZ
1. Which of the following are primary causes of DIC? (select

all that apply)

a.
b.
c.
d.
e.
f.
g.
h.
i.
j.

Shock
Septicemia
Mismatched blood transfusions
Abruptio placentae
Cancer
Fat and pulmonary emboli
Acute anoxia
Burns
Snakebites
Systemic lupus erythematosus

QUIZ
1. Which of the following labs are prolonged in DIC?
a. PT
b. PTT
c. Fibrinogen
d. Platelets

QUIZ
1. Which of the following labs are prolonged in DIC?
a. PT
b. PTT
c. Fibrinogen
d. Platelets