This handout is for disseminated intravascular coagulation (dic). Your care team identified this based on: thrombocytopenia + abnormal pt/aptt in critically ill patient (isth 2009).
Other reasons your team may use this plan: bleeding from ≥2 sites (line, mucosal, surgical, wound) (isth 2009); digital ischemia, purpura fulminans, organ dysfunction with consumptive coagulopathy (isth 2009); aml m3 / apl with bleeding diathesis (eln apl 2019).
Take these medications exactly as prescribed. Do not stop or change a dose without talking to your provider.
| Medication | Starting dose | How | When | What it does |
|---|---|---|---|---|
| fresh frozen plasma (FFP) | 10-15 mL/kg | IV | reassess after each unit | Replace coag factors; aim INR <1.5 |
| cryoprecipitate | 1 unit/10 kg (or 10 units pooled) | IV | reassess | Target fibrinogen >150 mg/dL in active bleed; >200 in OB |
| platelets | 1 apheresis unit | IV | target ≥50 K (≥100 K CNS or active bleed) | Maintain platelet count for hemostasis |
| prothrombin complex concentrate (PCC) | 25-50 IU/kg | IV | single dose | Rapid factor replacement; preferred over FFP for warfarin |
| vitamin K (phytonadione) | 5-10 mg IV/PO | IV/PO | single | Reverse warfarin / liver vitamin K deficiency |
| tranexamic_acid | 1 g IV over 10 min then 1 g over 8 h | IV | short course | NOT routine in DIC — only when hyperfibrinolytic phenotype documented; risk of thrombosis |
Plan: Supportive blood-product replacement for bleeding phenotype
Call 911 or go to the nearest emergency room right away if you have:
Hematology, oncology, OB, ID per cause; thromboprophylaxis once safe
Guideline: ISTH 2001 Taylor DIC score + Wada DIC harmonization (JTH 2013) + Levi NEJM 1999 review + SCARLET JAMA 2019 + ELN APL 2019