And then...All hell broke loose...
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One of the gals at the broomcloset where I do a little weekend PRN had a baby last week, so I was helping out the crew by covering a 1-9 yesterday afternoon.
Surgeon had a patient the ED doc had admitted over the weekend with a positive occult blood and a hematocrit in the low 30's. They'd scoped this lady Monday morning and had not seen the cause of the bleed. Crit at this time was 29.
She must have passed something that lit a fire under the surgeon, because he hauled her to OR at 1630 and I got a H&H from them as they were putting her on the table. After I called to let them know her crit was 18, things jacked into high gear. I had a preop T&S with that specimen, so I knew she was an O+, but my AB screen wasn't done, which meant we went to emergency release, type-specific. 8 units and 6 FFP later (we don't keep cryo on hand and the 6 FFP's were all type AB [and all we had]), they closed.
I don't know exactly what happened, but my phlebe (who was carrying the blood to OR) said one of the nurses mentioned something about the mesenteric.
So, a question for my OR folks...more likely artery or vein? And how common is something like this? That's like a 3 unit drop in six or seven hours after the scope.
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There's only a few things that'll cause such a rapid drop in the Hct - and all of them involve a lot of bleeding, and none of them are good.
Mesenteric artery is usually associated with a thrombosis, not bleeding.
Is it possible the endoscopy got a major vessel?
@bachophile ? Thoughts?
