The seial thrombin time in the diagnosis of consumptive coagulopathy

Acute consumptive coagulopathy may be initiated by diverse events. It is frequently necessary to establish the diagnosis with urgency. Rational therapy can only be approached with knowledge of the relative impact the primary consumption exerts upon hemostasis as well as the effects of secondary fibrinolysis. A constellation of interlocking tests within the capability of the small laboratory is presented. This includes the prothrombin time, the activated partial thromboplastin time, the serial thrombin time, the heat precipitation fibrinogen level, the platelet count, red cell morphology, the levels of fibrin (fibrinogen) degradation products and selected factor assays. This series can be completed within 45 minutes. Interpretation, with particular emphasis upon the stage in the natural history of the process when evaluation is instituted, and underlying diseases which modify typical patterns are discussed. The discriminant function of the serial thrombin time is stressed.