Well, I ain't never seen that before...

[Jolly]

Patient is hauled by the family to the ED. Patient is not quite coherent, so onto a gurney she goes.

My CBC will not run through the instrument. Says there is no blood being aspirated. Usually that's a clot, but not in this case. I have to call the national help line, and they tell me to disable the blood sensor. She's a little septic, but the hemoglobin is eye-popping.

3.0. The machine doesn't think it's blood, cuz there ain't many red cells.

Confirmed by repeat sample from a PICC line.

Guess it goes with her platelet count of 6.

She's not a CA patient, so I dunno. I've seen some low hemoglobins on living patients, but I think this is my record.

[George K]

Platelets were SIX THOUSAND??? That might account for the Hb of 3.

JFC.

[Mik]

6? Wow. I’m dealing with platelet counts in my current cancer SX studies but I’ve not seen anything even in that same universe. They’re all like 150k to 250k.

[Jolly]

Ok, I lied. Because the ED lied to me. We didn't have a history on the patient. Daughter came in later and confirmed she is a CA patient.

But I've made her happier. Since my little post above, I've given out 3 units of LRPC, 2 FFP and 1 platelet pheresis.

Now, I've got a doc breathing down my neck for more, but I'm dragging my heels. Without an active bleed and blood on the floor, I don't like chunking too much too fast. Besides, I just talked to one of the nurses on the floor and they said they had no admits, which means the doc is gonna adios her to an ICU, somewhere else. O pos is on my short list and I ain't gonna let some doc chew through what I can't replace...Not if I don't have to...

[Jolly]

@George-K said in Well, I ain't never seen that before...:

Platelets were SIX THOUSAND??? That might account for the Hb of 3.

JFC.

Now, tell me you don't miss this shit. It's innervating.

[Mik]

I’m really enjoying my consulting gig. Learning some new part of Epic and research every day, plus all the project management and HR functions. Great for my head, and not a lot of hours.

[Jolly]

@Mik said in Well, I ain't never seen that before...:

I’m really enjoying my consulting gig. Learning some new part of Epic and research every day, plus all the project management and HR functions. Great for my head, and not a lot of hours.

It is good to stretch the brain. Glad you're having fun doing it...

[George K]

@Jolly said in Well, I ain't never seen that before...:

Now, tell me you don't miss this shit.

OK.

I don't miss this shit.