Lowest H/H I ever saw...

Specialties CCU

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...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 drainage from RLQ Blake. A.M. H/H 5/15, repeated. Anyone else?

...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 drainage from RLQ Blake. A.M. H/H 5/15, repeated. Anyone else?

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??:confused:

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.:o

Specializes in NICU.
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??:confused:

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. :uhoh3:

Specializes in Critical Care, ER.
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:

The lowest I've seen was 5 and 12 in sickle cell crisis.

Specializes in NICU.

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.

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.

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.

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.

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.

Specializes in Neurology, Neurosurgerical & Trauma ICU.
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!!! :uhoh3: :eek:

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.

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