Part 1: Disseminated Intravascular Coagulation

Thomas G. DeLoughery, MD, FACP

Dr. DeLoughery is a professor of medicine, Departments of Pathology and Pediatrics, Oregon Health Sciences University, Portland, OR.

Question 4

An 18-year-old man who drove his car off the road while texting his girlfriend is brought to the emergency department with multiple long bone fractures, a ruptured spleen, and a liver laceration. What steps should be taken to prevent the most common complication of massive transfusions in this patient?

  •  Bicarbonate infusions to keep blood pH at 7.35
  •  Blood warmers and damage control surgery
  •  Empiric infusion of calcium after every 2 units of plasma
  •  Frequent blood test for hyperkalemia
  •  Limiting plasma infusion to prevent citrate accumulation

Updated 7/8/2010 • adb | Copyright ©2013 Turner White Communications