II. Labs: Coagulation studies
- ProTime (PT)
- Partial Thromboplastin Time (PTT)
- Fibrin split products (Fibrin Degradation Products)
- Fibrinogen
- Clot Test (4-8 minutes is normal clotting time)
III. Management: General
- Specific underlying Coagulopathy cause
- Replace Fluids
- Replace Coagulation deficits
IV. Management: Fresh Frozen Plasma (1 unit) Indications
-
Fibrinogen <100 mg/dl
- FFP 1 unit increases Fibrinogen 10 mg/dl
- Partial Thromboplastin Time (PTT) >60
- ProTime >18 (INR >3)
- Following every 5-6 Platelets transfused
- Following every 4-8 units packed RBCs transfused
V. Management: Packed Red Blood Cell (1 unit) Indications
- Hematocrit below 27 to 30%
- One unit packed RBC will increase Hematocrit 3%
- Consider Fresh Frozen Plasma after 4-8 pRBC units
VI. Management: Platelet (1 unit) Indications
- Platelets <50,000
- Platelets 1u will increase Platelets 5-10,000
- Consider Fresh Frozen Plasma after 5-6 Platelet units