Celebrating Creativity: Understanding DIC Through the Lens of Theater

Simplifying the Complicated.  Enjoy this clever illustration of DIC (Disseminated Intravascular Coagulation) by blogger Renee Thompson at rtconnections.com.

  

CLINICAL NURSING TIP: UNDERSTANDING DIC -

ACT 1, ACT 2 

I teach many clinical courses to nurses all over the country and frequently get the deer in headlights look when I mention DIC. Just thinking about the clotting cascade can send any nurse, especially a new nurse, into SVT!! DIC really isn't as difficult to learn as you may think. To understand DIC, you just need view it as a play with a plot, characters, and with different acts.

Once you understand the basics, you can learn the rest.

The Plot

DIC doesn’t occur out of the blue. There is ALWAYS a precipitating event or villain. This event could be overwhelming sepsis, a gunshot wound to the abdomen or other major trauma, an amniotic or fat emboli, or any shock state. The key is to figure out, “Who done it?”

The Characters

Once this event occurs, the body responds by sending all of it’s clotting factors to “save the day.” The body sends platelets, fibrin, and other clotting factors. Basically, anything in your body that plays a role in clotting is sent the scene of injury.

ACT 1: Clotting

 Using the example of a gunshot wound to the abdomen – your body says to itself, “Holy Crap! We have a gunshot wound to our abdomen. We have to send our clotting army to stop the bleeding or else we’ll die.”

Think about it…now you have every clotting cell/factor in one location. What do you think will happen?

Yep….when you get all of your clotting factors together in one location, they’re going to bump into each other and start clotting like crazy!

DIC starts with clotting, clotting and clotting. The body will start clotting and then will send those clots throughout the body resulting in strokes, arterial clots – intermission!

ACT 2: Bleeding

Once your body has saved the day by sending all of its clotting army to the site of injury, all of a sudden, your body doesn’t have any clotting cells/factor anywhere else, and starts bleeding.

If you drew blood from your patients arm an hour ago, this is why that puncture site starts to bleed – it’s because all of your body’s clotting factors are sitting at the scene of injury!

Medical Morales to Remember:

• DIC is something that happens in response to an event in which the body starts clotting, clotting, clotting while simultaneously – bleeding, bleeding, bleeding.

I hope you enjoyed the show!  Thanks for reading. Thank you for becoming a nurse!  I’m cheering for your success!

Renee Thompson, MSN, RN, CMSRN

CCO of RTConnections, LLC

www.rtconnections.com                                                                           

Renee Thompson has more than 23 years healthcare experience including clinical practice, nursing education, quality management and executive leadership.  This diverse experience has afforded Renee the unique ability to view the delivery of healthcare from a 360° perspective.  Renee is the Chief Connections Officer at RTConnections, LLC, an organization that educates, connects and inspires current and future nurses.

Renee is a published author of the book, “Do No Harm” Applies to Nurses Too! Strategies to protect and bully-proof yourself at work.  She speaks nationwide to healthcare organizations and academic institutions motivating her audience at keynote addresses, professional conferences, workshops, and seminars.  Her presentations and seminars focus on improving clinical and professional competence, eliminating nurse-to-nurse bullying, effective communication and leadership, building a positive and healthy workplace, and nurturing a culture of respect.

Additional Resources: 

• New Nurse Success Shop - resources for new nurses from Renee Thompson
• UpToDate - DIC
• National Heart, Lung and Blood Institute - What is Disseminated Intravascular Coagulation?

Was this article helpful?  Have you ever taken care of someone with DIC?  What are your thoughts?