reference sheet lab/coagulation-profile

Coagulation Profile

what this result means

escalate now if

active bleeding, or unstable → bleeding; reverse by drug: warfarin, DOAC, heparin
INR > 5 · fibrinogen < 1.5 g/L · profile worsening fast → products
suspected DIC → DIC

PT / INR alone → warfarin, liver disease, vitamin K deficiency
APTT alone → heparin, factor deficiency, lupus anticoagulant (prothrombotic in vivo, not a bleeding risk)
both → DIC, severe liver disease, massive transfusion
high D-dimer + low fibrinogen + low platelets → DIC until proven otherwise (sepsis, malignancy, trauma, obstetric)

bleeding? meds: warfarin, heparin / LMWH, DOAC, antiplatelets; liver disease, sepsis, recent surgery or transfusion
CBC, blood film, fibrinogen, D-dimer, LFT; group & screen if bleeding

bleeding → two large cannulas, group & crossmatch, hold anticoagulants, treat the source
warfarin → no bleeding → hold; INR > 8 → vitamin K 1–5 mg PO; major bleeding → PCC 25–50 units/kg IV by INR + vitamin K 10 mg IV
DOAC, major bleeding → hold, creatinine + time of last dose; dabigatran → idarucizumab 5 g IV; apixaban / rivaroxaban → 4F-PCC 25–50 units/kg IV; hematology
heparin → protamine 1 mg per 100 units given in the last 2–3 h, max 50 mg IV over 10 min; enoxaparin → protamine 1 mg per 1 mg if within 8 h (partial reversal); fondaparinux → hematology
DIC → treat the cause; products only if bleeding or a procedure is planned
products → FFP 15 mL/kg; fibrinogen < 1.5 → cryoprecipitate (target > 1.5, > 2 in obstetric bleeding); vitamin K 1–5 mg PO/IV for deficiency or cholestasis
no bleeding, mild prolongation → do not correct a number before a low-risk procedure
recheck PT / INR / APTT / fibrinogen after correction and before any procedure
hematology → DIC, unexplained coagulopathy, before reversing a DOAC · ICU: major bleeding, unstable
hand over → last profile + trend, products given, next check due

source	type
ISTH DIC scoring criteria	international guideline

Verify indication, dose, allergies, interactions, renal/hepatic function and local protocols before prescribing.

free the on-call checklist covers the whole shift on one printable page.

More clinical resources in the MOC+ Library →

reviewed Aug 2026updated Oct 2026file lab/coagulation-profile