Disseminated intravascular coagulation (DIC) may occur in a trauma patient following one or more precipitating events. Identification and correction of the underlying causes is important for the management of the DIC.
Tissue necrosis:
(1) crush injury
(2) brain necrosis
(3) lung necrosis, including pulmonary embolism
(4) acute hepatic injury
(5) rhabdomyolysis
(6) ischemia or vascular injury/surgery
(7) burns
(8) pancreatitis
Hypotension related
(1) shock, including use of an aortic balloon pump
(2) multi-organ failure
Concurrent conditions:
(1) pregnancy
(2) hepatic cirrhosis
Miscellaneous injury:
(1) hypothermia or hyperthermia/heat stroke
(2) asphyxia, hypoxia, or inhalation injury
(3) hemolytic transfusion reaction
(4) massive amniotic fluid, fat or air embolism
(5) near drowning
A patient with one or more of these conditions plus clinical signs of bleeding should be screened for DIC.
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