Michael P. D'Alessandro, M.D.
Peer Review Status: Internally Peer Reviewed
Primary hemostasis is secondary to platelets, check via platelet count, bleeding time (can increase in patient with aspirin).
Secondary hemostasis is secondary to fibrin
Check extrinsic pathway via patient (Coumadin increases it via inhibiting
Vitamin K [ reverse with FFP]).
Check intrinsic pathway via PTT (heparin increases it by increasing antithrombin[reverse with protamine])
Increased patient is extrinsic problem
Increased PTT is intrinsic problem
Increased patient and PTT is problem in X, V, prothrombin, fibrinogen
Increased TCT in patient with problems going from fibrinogen -> fibrin
Clot solubility test diagnoses clot defects
In DIC you see increased patient and PTT, TCP, hypo fibrinogen, increased FSP
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See References Chapter.
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