Published Jul 23, 2016
shereese
5 Posts
A pt on the tele unit was found lying in bed wth several blood clots around his. His face covered with a large blood clot blood coming for his ears even. Airway impeded with blood and several blood clots. Noted smoker. Pnuemonia pt. Dont know too much elses because he wasn't my pt. Have anyone experienced any thing like this before?
psu_213, BSN, RN
3,878 Posts
Why did the nurse go into the room? Regular rounding or did the pt. ring? Was the pt. conscious? Could he have fallen? Did the clots come out of a wound? Was the clot by he ear, or was it actually coming from somewhere "in" his ear? Did he cough up the clots?
It really is tough to say what happened without knowing a bit more of the background.
AJJKRN
1,224 Posts
Esophageal varices history...?
roser13, ASN, RN
6,504 Posts
Thats what I wondered, but too little info to say. Also wonder if this is homework.
Just signed up today to post this.
No not homework he wasnt my pt I assisted with the code, i never seen anything like that before so i was hoping allnurses could open my eyes to different possibilities of causes. There was so much blood and from his nose throat and ears.
Thank you could that make you bleed from the nose and ears
Remy Ox
52 Posts
If not esophageal varies what about. Ruptured thoracic aortic aneurysm. Those can constrict upper passages leading to pneumonia and can eventually burst but I would suspect not just clotting as most I've seen we fresh blood oozing and coughed up, not much time to clot right when it happen. Possible brain injury/surg/trauma.
Too many possibilities to speculate.
Thanks for all comments y'all are great
brownbook
3,413 Posts
I am 99% sure the patient was not bleeding from his ears????? If you are lying supine in bed and start coughing up, or vomiting up, blood, it is going to come out your mouth and nose, then follow the laws of physics and gravity, and flow down towards the patients ears!!!
I didn't think of it at first, but sounds like esophageal varicies, GI bleeder. Yikes, those things can be a mess. The bleeding was from varecies in his esophagus, he vomited up blood, and it went everywhere.
When your stomach get a moderate or large amount of blood in it, even if it is your own blood, I forget why...but your body hates it and you will vomit it up. I guess it could have been a bad nose bleed, or s/p tonsillectomy? A major facial/dental reconstruction?? Many things can make the nose, mouth, teeth, esophagus, stomach, bleed and all the blood is going to be vomited up.
Hopefully a patient will be able to turn to their side, or sit up, and vomit on the bed or floor. An obtunded patient may not be able to do this.
OscarTheOwl
113 Posts
Any sepsis from the pneumonia? I thought GI bleed too, possibly some coagulopathy like DIC
I was leaning toward dic from the pneumonia-sepsis
I wish i had more information, the pt unfortunately didnt make it
Closing this one out with a prayer for his family.Thank everyone for their imput.