Lowest H/H I ever saw...

Specialties CCU

Published

...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?

Specializes in Nurse Scientist-Research.

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.

Up Vote Up Vote ×

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....:)

Up Vote Up Vote ×
....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....

i too left a cardiac care unit and now work in a different area (ed for me). it took me a while to get used to running a 2l bolus wide open as well. i was so accustomed to using fluids sparingly in my heart folks that i forgot there are otherwise healthy individuals on the planet (they complain far more than cardiac folks though).

the experience often pays off and i sometimes get to play experienced cardiac nurse when i catch the ed doc trying to bolus someone i would typically be cautious with. i'm still quick to tell the doc "i'll just run ntg and titrate for pain and keep spb less than 140 and great than 90 and repeat ekgs with pain change or increase in ectopy....just write the order when you get a chance...btw you want an integrillin bolus and gtt?".

i know i still get cross-eyed though when i read "2l ns wide open"

Up Vote Up Vote ×
Specializes in ORTHOPAEDICS-CERTIFIED SINCE 89.

I think 4.2 was about the lowest Hgb I've seen. That was in someone who had been losing slowly. I have seen some people with religious reasons for not taking blood even go to elective surgery in the sixes. Now I had a lady once who literally rolled over in bed and ruptured her spleen. She went from the twelves to the fives VERY fast.

Up Vote Up Vote ×

Believe it or not, I had a patient with H&H of 1 and 6. Young female, intraab bleeding from prior GYN surgery, was in ER for a while, went unconscious and then the lab called with H&H report. Went to surgery by OB-GYN, general surgeon also called in. Withdrew care in unit due to severe brain anoxia. Will never forget this patient :(

Up Vote Up Vote ×

Years ago a young woman--early 20's -- walked over from her dr's office about a block away. Her H/H was 3/17. She said she was 'just a little tired'. I forget the circumstances about her anemia. She wasn't an oncology or sickle cell patient, though.

We get Hgbs in the 5-6 range and Hcts in the 18-22 range periodically in our hem/onc pts.

Up Vote Up Vote ×

My sister, who had her stomach stapled 15 years ago, thought she was dying and finally decided to go to the doctor after she had to literally push her legs out of bed in order to get up in the morning. She is a daycare provider of 5 children and had no energy whatsoever. So she goes to the doctor and gets some lab drawn and a few days later, the clinic's nurse shows up at her door AT HOME ON SUNDAY and tells her to go to the hospital immediately for a transfusion. Her Hgb was 3.2--I forget the Hct.

Up Vote Up Vote ×

Walked into the ER and told the triage "I had some bleeding when I went to the bathroom" Said I felt a "little weak but that's all". Seemed alert a little pale but not too bad. p=140 BP=88/50 bang zoom w/c into ER on Gurny and IV NS. H/H = 6/13. This was me I had alot of bleeding. I was not as alert as I seemed. I actualy don't remember getting to the ER. The folks there told me how alert I seemed after I had been treated. This is how I found out that my family has a HX of stomach ulcers. Not enough Bicarb or too much Acid. Have been fine since with meds. Normaly I'm healthy. I don't know why I didn't just pass out. Beware of "walking and talking" with low H/H.

Up Vote Up Vote ×
Specializes in NICU.

Just noticed that I replied to this thread already!

Up Vote Up Vote ×

Young mom post emergent c section, must have nicked a uterine artery, kept bleeding had 20 units of blood total in 12 hours, plasma, plt, prbc, cryo. Had a hgb of 1 at one point in time. Was transfered to cleveland clinic with a hgb 5-6. Stable, found to have a large clot in the uterine area caused DIC. This was an amazing, and ultimately great outcome, everyone was healthy, mom home within 2 wks.

Up Vote Up Vote ×

Had a patient the other night go from a crit of 37 to 22 in 3 hours--not sure what the hgb was. Upper GI bleed. between vomiting and the NG tube, we got 1400 cc of blood out of her stomach before sending her to the unit. Last BP on the floor was 48/??. One of the other nurses saw her being RAN into the OR an hour after we sent her to the unit.

Up Vote Up Vote ×
Specializes in CCU.

My pt was a leukemic pt, in his 80's full code with a sbp 90, hr 90s, pale as a ghost c/o cp on tele unit. The pt was admitted 1 hour before my shift, it was going to be a long 12 hrs!

The PMD had a consult for hematolohy, GI and oncology. I called them all but they did not know the pt. I did not have time to wait for compatible blood, so someone had to sign the permission for tranfusing incompatible blood. None of the specialist want to come in (of course, it was not their job, even if the PMD was insisting that I called them to sign it). :crying2:

The PMD never got to see the pt in the ER because it's supper time and the day is over for them. His Hgb was 4.9 at 6 pm, I drew another one and he was 3.5-14. I had to transfuse him. He was also c/o CP (obviously symptomatic) while his neighbour that I was titrating dopa wanted the bedpan, tissues and a glass of crandberry juice!

Chaos! While I am dealing with this poor man who is now diaphoretic, I am giving IV fluid wide open, nobody want to give the order for that either (Gosh, he may get to CHF!) :angryfire

Now try to transfer this dead guy in the ICU, to hear the sup say: I hope this is worthwhile! It's finally, 10 PM when I got the pt in ICU, that the PMD came in to sign the blood transfusion paper! Hikes!

I still had to see my other 6 pts, and pick 3 more for 11 PM. What a nite! I now work in the ICU! :balloons:

Up Vote Up Vote ×
+ Add a Comment