Bleeding treatments: Difference between revisions

(Created page with "==Treatments== 1) PRBCs 2) DDAVP (0.3mirog/kq SQ/IV) 3) Platelets 4) FFP 5) Cryopreticipate 6) Vitamin K (10mg SQ/IM) 7) Protamine (Heparin) 8) Estrogen (Renal) 9) PPI/...")
 
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==Treatments==
==Treatments==
#[[Packed_red_blood_cells|Packed Red Blood Cells]]
#[[DDAVP]] 0.3mg/kg subQ or IV (max 20mg)
#[[Platelet transfusion|Platelets]]
#[[Fresh frozen plasma|FFP]]
#[[Cryoprecipitate]]
#[[Vitamin_K|Vitamin K (10mg SQ/IM)]]
#[[Unfractionated_heparin_reversal|Protamine (Heparin reversal)]]
#Estrogen (Uterine, renal)
#[[PPI]]/[[famotidine]]/[[octreotide]] ([[GI bleed|GI]])
#[[Quick_Clot_(Kaolin)|Quick Clot (Topical)]]
#[[TXA]]


==See Also==
*[[Coagulopathy (Main)]]
*[[Hemorrhage]]
*[[Blood products]]
*[[Massive transfusion]]


1) PRBCs
==References==
 
<references/>
2) DDAVP (0.3mirog/kq SQ/IV)
 
3) Platelets
 
4) FFP
 
5) Cryopreticipate
 
6) Vitamin K (10mg SQ/IM)
 
7) Protamine (Heparin)
 
8) Estrogen (Renal)
 
9) PPI/Pepcid/Octreotide (GI)
 
 
==Warfarin/Vitamin K Def==
 
 
(inc PT/INR)
 
-FFP
 
-Vitamin K (+/- takes 24hrs to affect & 2wk to wear off)
 
 
==Heparin/Lovenox==
 
 
(inc PTT)
 
-Protamie (1mg IV Q100 U of heparin in previous 4hrs)
 
-Massive bleed --> cryoprecipitate (10 U IV), then FFP (& platelets, aminocaproic acid infusion if nec)
 
 
==Liver Disease==
 
 
-Vitamin K
 
-PPI/pepcid/octreotide (variceal bleed)
 
-FFP (& platlets if low)
 
-DDAVP
 
 
==Renal Disease==
 
 
-PRBCs (<8 Hb)
 
-Hemodialysis
 
-DDAVP
 
-Conjugated estrogens (unknown mechanism)
 
-*Cyroprecipitate & platelets (in life-threatening bleed only)
 
 
==DIC==
 
 
(see also DIC)
 
-IVF
 
-PRBCs
 
-Vitamin K
 
-Folate (1mg IV)
 
 
If bleeding predominant DIC:
 
-FFP (2 U at a time)
 
-Cryoprecipitate (10 bags at a time)
 
(Heparin is contraversial in thrombosis predominant DIC)
 
 
==Factor VIII Inhibitor==
 
 
(PTT does not correct after mixing)
 
-high dose Factor VII, prothrombin, or recombinant factor VIIa
 
 
==Lupus Anticoagulant==
 
 
(rare)
 
-warfarin or ASA
 
 
==Source ==
 
 
1/22/06 DONALDSON (adapted from Tintinalli's)
 
 
 
 
[[Category:Heme/Onc]]
[[Category:Heme/Onc]]

Latest revision as of 15:30, 27 January 2022