I. Labs: Coagulation studies

  1. ProTime (PT)
  2. Partial Thromboplastin Time (PTT)
  3. Fibrin split products (Fibrin Degradation Products)
  4. Fibrinogen
  5. Clot Test (4-8 minutes is normal clotting time)

II. Management: General

  1. Specific underlying coagulopathy cause
  2. Replace Fluids
  3. Replace Coagulation deficits

III. Management: Fresh Frozen Plasma (1 unit) Indications

  1. Fibrinogen <100 mg/dl
    1. FFP 1 unit increases Fibrinogen 10 mg/dl
  2. Partial Thromboplastin Time (PTT) >60
  3. ProTime >18 (INR >3)
  4. Following every 5-6 platelets transfused
  5. Following every 4-8 units packed RBCs transfused

IV. Management: Packed Red Blood Cell (1 unit) Indications

  1. Hematocrit below 27 to 30%
  2. One unit packed RBC will increase Hematocrit 3%
  3. Consider Fresh Frozen Plasma after 4-8 pRBC units

V. Management: Platelet (1 unit) Indications

  1. Platelets <50,000
  2. Platelets 1u will increase Platelets 5-10,000
  3. Consider Fresh Frozen Plasma after 5-6 platelet units

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