 Welcome to Nursing School Explained in this video on disseminated intrabascular coagulopathy or sometimes also abbreviated as DIC. Again, we can look at the terminology here to really almost get a better understanding of what's the underlying pathophysiology. So disseminated basically just means widespread throughout the organ or the body, intrabascular within the blood vessels and coagulopathy, so a disease or a problem with the coagulation. And really what it is is an abnormal response of the normal coagulation cascade. And you may remember from physiology all the different steps that happen in the coagulation cascade and the different factors that are involved. So DIC just involves a very abnormal response to the coagulation cascade as it should naturally occur. Now several things can cause DIC and all of those similarly get very different but they all lead to the same end result which is this complication that can be life-threatening. So very common cause is that any kind of shock states that the patient can be in. So neurogenic shock, hypovolemic shock, cardiogenic shock, any kind of shock that you can imagine. And then sepsis is a very common cause of DIC as well as transfusion reactions can lead to coagulation problems and DIC. And then there are several gynecological or obstetrical things that can lead to DIC. First of all is help syndrome, then we have amniotic fluid emboli or an abruption of the placenta can all lead to abnormal clotting and DIC. Now certainly blood disorders such as leukemia or metastatic tumors can also lead to DIC, burns as well as trauma can cause a problem and snake bites that are poisonous can lead to issues with coagulation and DIC and acute anoxia such as would occur after a patient returns to spontaneous circulation after a cardiac arrest or maybe after an acute drowning when the patient is revived and has acute anoxia it can also lead to DIC. So as you can see most of these are already kind of very high risk events that can lead to this complication that then exasperates the problem. So the pathophysiology there are basically two things that occur here. So first of all we have the thrombotic stage which is the problem of the clotting. So if you recall from your physiology classes that thrombin is needed to convert fibrin to fibrinogen to actually build the blood clot. And this leads to increased platelet aggregation because the platelets want to solve the problem of this whatever needs to be fixed. And then a thrombus occurs which is usually a good thing but in this case it's just too much of a good thing. So now we have thrombi everywhere in the body and they can settle and then cause a lot of complications. And then number two we have the bleeding stage or the bleeding phase where now these clots are broken down by something called fibrin split products or FSP. And then the body is unable to clot because everything is used up all these platelets are used up and whatever clots we have they're broken down and the body cannot clot which then will lead to hemorrhage. So it's kind of a conundrum we have clotting and bleeding at the same time and we know that either one of them can be very complicated to manage. But now we have these two problems that can sometimes occur at the very same time in the same patient.