Blood

We need it to survive. It’s that simple, but also can be quite complex.

2 patients, 2 very different needs.

Patient A: Sent to ER because her bloodwork done by an independent lab is totally out of whack. At triage, the only indication that she had anything remotely wrong with her was the colour of her sclera…and the creases on her forehead and between her eyebrows. I couldn’t get even a hint of a smile from this patient. On the “quick look” triage….my “nurse senses” were on yellow alert.

Patient B: Called EMS following a Day Surgery procedure to find the floor and toilet full of the bright red stuff after using the throne at home. At triage, the pallor of his skin, the report from EMS and the plastic yellow sheet wrapped around the patient’s lower half put me on red alert with this one.

Patient A: Her type and cross turned out to be very complicated, thus a sample was sent to our big hospital to be analysed even more. The blood transfusion is delayed for hours. She was alert, awake, dressed and visiting with family while her units were located.

Patient B: Despite type and cross, due to the severity of his immediate loss, a hemoglobin of 75 and his rapidly deteriorating hemodynamic stability, he received 4 units of blood very quickly. 2 units were cross matched properly and 2 units uncrossmatched due to the rush. His son paced by the bedside, signing consent to deliver the blood that would save his Dad. Patient B’s blood pressure was very low, he kept having intermittent losses despite all of our efforts and was whisked away by EMS with our nurse and a cooler full of more blood to pour in enroute.

What we think is a very simple thing, that we supposedly can receive so easily to keep us alive, can be so very complex in its delivery.