I teach many clinical courses to nurses all over the country and frequently get the deer in headlights look when I mention DIC. Just thinking about the clotting cascade can send any nurse, especially a new nurse, into SVT!! DIC really isn't as difficult to learn as you may think. To understand DIC, you just need view it as a play with a plot, characters, and with different acts.
Once you understand the basics, you can learn the rest.
DIC doesn’t occur out of the blue. There is ALWAYS a precipitating event or villain. This event could be overwhelming sepsis, a gunshot wound to the abdomen or other major trauma, an amniotic or fat emboli, or any shock state. The key is to figure out, “Who done it?”
Once this event occurs, the body responds by sending all of it’s clotting factors to “save the day.” The body sends platelets, fibrin, and other clotting factors. Basically, anything in your body that plays a role in clotting is sent the scene of injury.
Using the example of a gunshot wound to the abdomen – your body says to itself, “Holy Crap! We have a gunshot wound to our abdomen. We have to send our clotting army to stop the bleeding or else we’ll die.”
Think about it…now you have every clotting cell/factor in one location. What do you think will happen?
Yep….when you get all of your clotting factors together in one location, they’re going to bump into each other and start clotting like crazy!
DIC starts with clotting, clotting and clotting. The body will start clotting and then will send those clots throughout the body resulting in strokes, arterial clots – intermission!
ACT 2: Bleeding
Once your body has saved the day by sending all of its clotting army to the site of injury, all of a sudden, your body doesn’t have any clotting cells/factor anywhere else, and starts bleeding.
If you drew blood from your patients arm an hour ago, this is why that puncture site starts to bleed – it’s because all of your body’s clotting factors are sitting at the scene of injury!
Cliff notes version: DIC is something that happens in response to an event in which the body starts clotting, clotting, clotting while simultaneously – bleeding, bleeding, bleeding.
I hope you enjoyed the show!
Thanks for reading. Thank you for becoming a nurse!
I’m cheering for your success!