Perform immediate anticoagulation studies and platelet count.

  • Perform immediate coagulation studies such as, INR, Fibrinogen, AntiXa/aPTT, D-dimers, viscoelastography, and a platelet count.
  • Correct according to substitution protocol. Refer to Blood Products for more information.
Consider local hemostasis:
  • Endoscopic intervention for pulmonary or GI bleeding.
  • Surgical intervention, if appropriate.
  • Use Tranexamic acid and/or advanced hemostatic dressing to manage cannulation sites, other exit sites or wound bleedings as a first step approach, before surgical management.
In the case of ongoing, uncontrolled bleeding:
  • Consider platelet function testing, i.e., platelet transfusion.
  • Consider AVWS testing, i.e., desmopressin, VWF concentrate.
  • If evidence of consumptive coagulopathy/hyperfibrinolysis, consider Membrane Lung exchange.
  • Refer to Circuit Component Changes
  • Refer to Whole Circuit Replacement
This concludes Management of Bleeding.