Page 212 - Critical Care Notes

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HEMA/
ONCO
prevent bleeding. If pretransfusion count was low or normal → the count may be
50,000–100,000/mcL → bleeding. Repletion of platelets → enhanced function of
the coagulation factors and platelet plug formation. Platelets provide the surface
on which many of the factors are activated and fibrin strands are formed.
Clinical Presentation
■ Bleeding from areas other than the area of hemorrhage
■ Low platelet count
■ Prolonged PT, aPTT, and thrombin time
■ Decreased fibrinogen
Diagnostic Tests
■ PT/PTT
■ CBC
■ D-dimer assay
■ Fibrin degradation/split products
Management
■ Administer platelets.
■ Administer cryoprecipitate.
■ Replace electrolytes as needed.
■ Provide support to patient and family members.
Refer to previous sections on DIC and HIT.

Oncological Emergencies
Oncological emergencies are complications or conditions of cancer and/or its
treatments that require urgent or emergency interventions to avoid life-threat-
ening situations.
Sepsis
Sepsis is a condition in which organisms enter into the bloodstream and cause
activation of the host inflammation defense mechanism → release of cytokines
and the activation of plasma protein cascade systems → septic shock → multi-
system organ failure. Patients with cancer are at an ↑ risk for sepsis because of ↓
WBC and poor immune systems.
Clinical Presentation
■ ↑ WBC
■ Fever
■ Hypotension
■ Tachycardia
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