06.11.2013 Views

Coagulation Made Simple

Coagulation Made Simple

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Intraoperative Bleeding<br />

“Surgical”<br />

Discrete bleeding points<br />

Obvious source<br />

Typical scenario<br />

Find it: Look at potential sites<br />

“Coagulopathic”<br />

Diffuse oozing<br />

Late in case? Early in case? Pre-existing<br />

problem?<br />

(Get help, if needed)<br />

Venous<br />

Arterial<br />

Sudden?<br />

Progressive?<br />

Suspect congenital<br />

or pre-existing<br />

problem<br />

Treat as indicated<br />

Hematology assistance?<br />

Pack<br />

Get more help!<br />

Direct suture<br />

Ligate<br />

Pack and close<br />

Proximal and<br />

Distal control<br />

Transfusion reaction<br />

Medications<br />

Hypothermia<br />

Acidosis<br />

DIC<br />

Dilution<br />

Primary fibrinolysis

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