Trauma-Induced Coagulopathy

Introduction

The article “Trauma-Induced Coagulopathy” by E. Katrancha and L. Gonzeles III presents information about coagulopathy that is also called clotting disorder. The journal Critical Care Nurse provides interesting information that can enhance the practice of nurses. The criteria of the selected article are based on the importance of the represented information that was relevant because of the increased number of TIC occurrences. Another significant criterion is that the article not only represents the problems which can be faced by the patient but also the ways of their avoidance or prevention that can efficiently guide the nurse. Thus, the project can crucially contribute to the improvement of the nurses’ skills and broaden their knowledge, which can further help to save the life of patients.

The analysis of the article is divided into three steps that helped to study the represented data deeper. The first step is the overview of TIC’s risk factors. Coagulopathy is a problem with the normal blood’s coagulation. The process is complicated in the patients who have significant trauma (Katrancha & Gonzalez III, 2014). Abnormal coagulopathy can be caused by the depletion inactivation or dilution of normal clotting factors. TIC will be accelerated in case of the massive injury of the tissue. It can become a multifactorial problem accompanied by hypothermia, acidosis, hemdilution, and hypoperfusion (Katrancha & Gonzalez III, 2014). The simultaneous occurrence of hypothermia, acidosis, and hypoperfusion induces high risk of death. Besides, the risk factor of TIC is hypotermia that can be caused by the fluctuation of the temperature after taking off the clothes fr diagnostic and reduction of the temperature after injection of such drugs as muscle relaxants, sedatices, and opioids (Katrancha & Gonzalez III, 2014). Fluid resuscitation is another risk. The authors of the article argued that trauma patients have to be under continual monitoring of their reaction on the fluid administration for end-organ perfusion in mind. Furthermore, the third risk is related to the prescribed drugs because the affect of the antithrombotic drugs on the development of TIC is still unexplored (Katrancha & Gonzalez III, 2014).

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The analysis of the care diagnostic tools in the assessment and monitoring of TIC is the next step. The authors of the article revealed interesting data regarding the usage of TEG and ROTEM for the evaluation of elastic changes in clotting whole blood (Katrancha & Gonzalez III, 2014). The blood is put in a warm cup with a pin to a system of detection. The pin and cup swing relative to one another generating tracing, which divides into three parts that shows the different stages of coagulation over the time (Katrancha & Gonzalez III, 2014). Such parameters help the team to identify the right drugs and blood components for further usage in work. The results reported by ROTEM are reaction time, clot formation time, maximum amplitude, and lysis (Katrancha & Gonzalez III, 2014). The commonly reported parameters are EXTEM, FIBTEM, INTEM, and APTEM. The authors also described three figures that clearly demonstrated the process that could help to perceive the information easier (Katrancha & Gonzalez III, 2014).

The third step is the study of the effective management of TIC focused on the presentation the ways of the risk factors avoidannce or prevention. The moderate and severe hypothermia occurs when the temperature is approximately 25 C, which causes the increase of the blood pressure, heart rate, and respiratory rate (Katrancha & Gonzalez III, 2014). Thus, the nurse has to monitor the temperature of the patient and keep it reasonable in the department. The nurse should also have skills, which will help to identify the quantity of fluids and to guide the team toward the best options concerning the resuscitation in fluids. (Katrancha & Gonzalez III, 2014). The authors also emphasize that lower level of systolic blood pleasure than 90 mm Hg increases the risk of coagulopathy development three times (Katrancha & Gonzalez III, 2014). With the aim of avoiding the medicine risk, the nurses should know that there are four categories of drugs of the clotting regulation which include anticoagulants, antiplatelents, herbals, and fibrinolytics (Katrancha & Gonzalez III, 2014). Therefore, the task of the nurse is to possess appropriate skills that can help to identify the right medication for the treatment.

Conclusion

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The hypothetical project can significantly influence the nursing career because it helps to improve the previously gained knowledge and effectively use them in practice. The article helped to identify the risk factors connected with TIC as well as the ways of their efficient management that will help to avoid or prevent the complication of the situation. Besides, the project concentrated on the analysis of the graphs that represented the components of blood, fluids and role of the tools for performance of diagnostic that can aid to evaluate TIC and significantly facilitate the process of diagnostic.

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