RT Book, Section
A1 Hillman, Robert S.
A1 Ault, Kenneth A.
A1 Leporrier, Michel
A1 Rinder, Henry M.
SR Print(0)
ID 1127766186
T1 BLOOD LOSS ANEMIA
T2 Hematology in Clinical Practice, 5e
YR 2016
FD 2016
PB McGraw-Hill Medical
PP New York, NY
SN 9780071626996
LK accessbiomedicalscience.mhmedical.com/content.aspx?aid=1127766186
RD 2024/04/19
AB CASE  HISTORY  •  Part  1A  27-year-old  man  is  brought  to  the  emergency  room  by  the  rescue  service  after  suffering  significant  blood  loss  from  a  chain  saw  laceration  of  the  right  thigh.  The  EMTs  have  applied  a  pressure  dressing  to  the  wound  and  initiated  an  intravenous  saline  drip  at  a  rapid  rate.  Vital  signs  in  the  field  were  BP  -  110/60  mm  Hg,  P  -  120  bpm,  R  -  22  bpm.On  examination,  the  patient  is  pale,  anxious,  and  breathing  rapidly  but  is  alert  and  able  to  answer  questions.  He  denies  other  illness  or  injuries  besides  the  thigh  wound.  Supine  vital  signs  are  BP  -  100/55  mm  Hg,  P  -  130  bpm,  R  -  24  bpm.  On  sitting  his  blood  pressure  falls  to  60/40  mm  Hg  and  he  feels  faint.A  second  intravenous  line  is  placed  and  blood  is  drawn  for  a  complete  blood  count  (CBC),  coagulation  profile,  and  STAT  type  and  crossmatch  for  4  U  of  red  blood  cells.  Ringer  lactate  is  infused  at  a  maximum  rate  and  vital  signs  are  continuously  monitored.  Surgical  consultation  is  requested.QuestionsBased  on  the  patient's  appearance  and  vital  signs,  how  much  blood  would  you  estimate  he  has  lost?In  order  to  correct  for  this  loss,  what  volume  of  Ringer  lactate/electrolyte  solution  should  be  infused  and  how  rapidly?Is  he  a  candidate  for  an  immediate  type  O-negative  blood  transfusion?