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  1. What is the first clinical sign of stress?
  2. Because all patients are stressed they are also?
  3. When should platelets be given?
    Only for dysfunctional platelets not for platelet count.
  4. What is DIC?
    A syndrome characterized by thrombus formation and hemorrhage secondary to over stimulation of the normal coagulation process, with resultant decrease in clotting factors and platelets. (Thrombus then hemorrhage)
  5. What factors trigger DIC?
    • Tissue breakdown
    • Platelet aggregation- stimulation (sepsis)
    • Injury to vascular endothelium(an IV site is an injury to this)and exposure to collagen- shock, endotoxin, acidosis or hypoxia, SIRS is activated
  6. What is the definition of a massive blood transfusion?
    6 units in a 24 hour period
  7. What is the first indication of DIC?
    Petechiae (especially on flanks)
  8. What are the clinical indications of platelet dysfunction?
    • petechiae
    • ecchymosis
    • purpura
  9. When can you see an elevated D-dimer?
    DIC, PE, Venous clotts, spesis, recent surgery
  10. What blood product should be given to a patient in DIC?
  11. What lab values can you expect in DIC?
    • <platelets
    • >PTT
    • >PT
    • <Fibrinogen
    • >FDP/FSP
    • >D-dimer
    • <Antithrombin III
  12. What causes risks in blood transfusions?
    • Noninfectious(human error)
    • Infectious
    • Immunologic
    • aged blood
  13. What are the indications to receive PRBC's?
    • Significant >H&H with normal volume
    • slow blood loss
  14. What are the potential complications of PRBC transfusions?
    • Transfusion reaction
    • Hepatitis
  15. What is Cryoprecipitate used for?
    • Raises factors VIII and XIII
    • prevents and controls bleeding
    • best for DIC
  16. Why would you give cryoprecipitate?
    Hemophilia A, con Willebrand's and DIC
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