Lowest H/H I ever saw... - page 2

...was on a post gastric bypass reversal. Worked with her all night, vitals stable as a rock. Feelin' fine, SaO2 99% on room air, SR 78, BP 120's, tummy soft, minimal pain, minimal serosang... Read More

  1. by   critcarenurse16
    postop with Hgb 3.5/Hct 14--arterial blood looked like diluted cool-aid! Develpoed a retroperitoneal bleed; we were unable to replace the blood fast enough for this poor pt.
  2. by   Gompers
    Quote from critcarenurse16
    Just curious if this pt had any reason her heart rate would not elevate with such a low H&H? Can you give some hx??
    Wondering if they were pumping her full of fluid and that stabilized the VS? Works in the short term, in my experience. We'll know a kid is anemic and needs blood, and the docs will just say, "Eh, just give another saline bolus..." and the VS will normalize for a few hours, until they order the next one.
  3. by   bluesky
    Quote from gwenith
    I have seen a Heamoglobin level of 2.6 on a patient who was walking - many years ago in Haemodialyis (Okay so mostly it was haemodiluted) in the days before erythropoetin. Her HB was so low we could have named her red cells individually!!! Poor lady I remember she wanted desperately to go on a flight over the Antartic but her HB was too low and the airlines would not take her. It was to be her last holiday. She never did make it - she died just before she was due to go but in one of those bizarre twists the Flight over the Antartic crashed into Mount Erebus and all were killed. Even if we had got her well enough she would have been on that flight - some people are not meant to live past a certain time.
    Whoa! Freaky, freaky, freaky! :uhoh21:
  4. by   PeninsulaRN
    The lowest I've seen was 5 and 12 in sickle cell crisis.
  5. by   Mimi2RN
    Newborn baby with H&H of 3 & 8, palest baby I'd ever seen, unfortunately we couldn't save him.

    A year or so later, I was at a c/s for a 35 weeker, Ped also at the section. As the baby came out, I realized it looked just like the other one. That time, everything went right. Labs drawn, IV in. Blood infusing within 20 mins. Her H&H almost as low as the other baby. Both of them had feto-maternal transfusion.
  6. by   AmiK25
    We had a trauma patient a couple weeks ago who had been stabilized (we thought and all his bleeds embolized) but he kept dropping his BP so his nurse drew an I-stat h/h and it read 0/0...uh, oh! When the lab h/h came back it was 2/6...his blood also looked like red kool-aid....and he went back to IR for another emoblization! He lived, though.
  7. by   steel magnolia
    3.9 on a lady w HIV. 4.1 on a lol who had a "toothache" with a slow bleed from her gums over about a week.
  8. by   my2sons
    Critcarenurse16: Tell me about it! I've racked my brain. She was a 34 y.o. 450# woman s/p gastric bypass 2 years ago. Her weight was down to 210#, she was experiencing N/V with every meal, and the doc said it was time to reverse her bypass. Meds: thyroid and vitamins. No beta blockers. No blood tx or colloids intra or post op, IVF at 125cc/hr, CVP was 7-9 all night,so she was not pumped full of fluids. Boy, did I feel like a dolt when her bloodwork came up during a.m. report. I immediately redrew the H/H and threw in a TEG and coag panel, too.
  9. by   JJRN
    Hct 2 Hmg 7...22y/o Jehovah witness...bleed out from scalp lac p rolling a Ford Explorer(other injuries easily manageable) Weeks on vent...epogen...iron...birth control pills. With lab draws qod, her blood literally looked like Hawaiian Punch. She walked back in months later and looked great.
  10. by   NeuroICURN
    Quote from JJRN
    Hct 2 Hmg 7...22y/o Jehovah witness...bleed out from scalp lac p rolling a Ford Explorer(other injuries easily manageable) Weeks on vent...epogen...iron...birth control pills. With lab draws qod, her blood literally looked like Hawaiian Punch. She walked back in months later and looked great.
    Holy Crap!!!
  11. by   oicu8bacilli
    Cool mechanism here.



    The numbers were only something like the 5/15 mentioned in the beginning, but the reason was pretty cool. The guy was on Plavix, ASA, and coumadin. He developed a mass on the neck of his pancreas, blocked his liver, and stopped metabolizing the coumadin. INR was 6 something and he was purple all over head to toe.
  12. by   TiffyRN
    Young lady, in her twenties. I don't even remember what was the cause of her anemia. Anyway, she had chronic anemia or obviously she would have been dead. She walked in to the ER complaining of "weak and dizzy". Her H&H was 1 and 5. She was admitted straight to the MICU for transfusions and when we got her her H&H was above 10 & 30. She was obviously was compensating for a very long time, she was known to be anemic.
  13. by   Mermaid4
    13 in a gyn patient who actually walked up to the floor. She, to say the least, was very pale, but not as pale as I was when I got the results of her labs. She was a vag bleed who felt well enough to walk over from the office....She did ok after some transfusions, and then I had a gentleman transfer over to our telemetry unit because he was "stable" according to the surgeons even though he was pale, had ringing in his ears, etc...Good thing he came over to our side because he ended up having an MI AND chf from the subsequent blood tranfusions he received for his previously undiagnosed bleed...Now a days in OB, asymptomatic hcts of 23 aren't treated and not uncommon...Sometimes blows a former cardiac nurses mind....But then, it took me forever not to have chest pain of my own when I discovered that we could run in liters and various boluses of fluid into laboring patients vs having them always on a buretrol....

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