ABSTRACT
This chapter discusses the disseminated intravascular coagulation (DIC), haemolytic uraemic syndrome, thrombotic thrombocytopenia purpura, and heparin-induced thrombocytopenia and thrombosis syndrome. Early symptoms of DIC are typically non-specific, such as: breathing, circulation, disability, and exposure. Although DIC is a medical problem, and treatments will be medically prescribed, nursing care can significantly reduce complications from trauma, sepsis and bleeding. Deep-vein thromboses can be fatal – pulmonary emboli are almost invariably from deep-vein thrombose. Deranged haemostasis often occurs with critical illness. In health, clotting involves a complex pathway combining intrinsic and extrinsic clotting factors. Intrinsic factors are those already in blood, produced by the liver; extrinsic are those released by vascular endothelium, so are sometimes called "tissue-dependent factors". Patients in intensive care unit are at especially high risk of developing deep-vein thrombosis owing to often prolonged immobility and pro-coagulant diseases and syndromes. Prophylaxis generally includes daily subcutaneous injection of low-molecular-weight heparin, knee-length anti-thrombotic stockings, and daily clotting screens.
