What is the lowest HGB you have seen?

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What is the lowest HGB you have seen on a pt. that is still alert, talking, upright, who exhibits no active bleeding?

LOL we had a little old lady present to the ER with "weakness" and her HGB was 3.2!:eek: I've not seen one that low before.

1.2 in a 4mo old boy...presented to ER for seizures and staff members were not as concerned about the seizures as they were about his pallor, tachycardia, and lethargy. Took a blood sample, came out like a chunk of jello, thought he might have cold agglutinin disease, sent to PICU for blood transfusion, blood washed and sent through a warmer, parents were told that he had a 50% chance of living d/t possible reaction to new blood and in that course they'd have to stop the transfusion but obviously he could not survive w/o any blood products. Kid was baptized and thankfully he had no reactions. Several more units of blood were taken and cold agglutinin disease was eventually ruled out and new diagnosis of Warm Antibody IgA-mediated Autoimmune Hemolytic Anemia, high dose steroids were prescribed and eventually 2 treatments of IVIG d/t anemia becoming refractory to steroids and then a chemo regimen was implemented. Cyclophosphamide and Vincristine q week x 10 weeks. Disease went into remission after many ups and downs and many HgB going from 9.0 or so to 5.0 overnight...kid is almost 3 today and has had a stable HgB w/ no meds since 8mo old.

THIS WAS MY SON! :) this is what made me want to become a nurse.

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2.1, little old lady who was shopping at the mall felt a little SOB. She went to a walk in clinic since she couldn't shake feeling tired and they sent directly over to the ICU.

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We had a pt the other day with non-stop nose bleeds who was at 4.X. He was almost continually getting blood products. ENT told the nurse to just stand there and hold pressure (nice- we're med/ surg, and she had 5 other pts; pretty sure that's not going to work), since IR wouldn't do the cauterization until morning, because they didn't consider it to be an emergency, and triage wouldn't move him to IMC or ICU just because he was otherwise stable. The only way to keep any blood in him was to continually replace it- that's stable?

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Specializes in Emergency/Trauma/Critical Care Nursing.

1.8 with no identifiable cause of blood loss! his diagnosis was "anemia not usually associated with life" :eek: but he lived, only to come back the next month w/a massive ICH, herniated and died in the ER.. his hgb that day was 13, go figure

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Specializes in Emergency.

2.5, came in c/o ha & feeling "a little dizzy when i walk".

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The lowest I've seen was 4. GI bleed.

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Specializes in ER, progressive care.

2.1. Alert & talking, no c/o other than "some fatigue." That bought them an admission and transfusion of blood products.

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Specializes in cardiac, oncology.

She was in her mid 40's. Not much history. Had been feeling tired for awhile, went to her doctor a couple weeks ago, he scheduled cardiolyte (which she passed). That was done a week before I saw her with Hgb of 3.2!! She was diagnosed with aplastic anemia, only lived about a month.

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Specializes in Nephrology, Dialysis, Plasmapheresis.

4.1-- A 21 year old nursing student came in on the suggestion of his barber, who said he "looked sick". Turned out he had nephrotic syndrome that he had fought most of his childhood and then stopped all treatment when he turned 18. His creatinine was 22 and BUN was 190. I felt so bad for him. We all felt invincible at that age and he must have thought it would just go away. He said looking back, he did feel pretty groggy and tired, but didn't think too much of it. After his first unit of blood and dialysis was sitting in his room joking with all his friends.

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wow...this all makes my 5.6 80 y/o seem paltry...3 units last night and an EGD this morning...not sure whats up since I'm a float nurse and I'm off tonight...

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Specializes in Emergency.

Pt came in via EMS for a fall. A&O x4, no SOB or cardiac complaints. BP stable. Lab calls with a critical hemoglobin of 2.4. A recollect is automatically ordered, based on that level. After the phlebotomist drew her, he showed us the tubes. Looked like cherry Kool-Aid. Repeat level comes back at 2.6.

I'm not entirely sure what her final diagnosis ended up being, because I left shortly after the second level came back.

Crazy!

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About 4.0. The patient had severe cancer mets spread throughout the GI tract. We transfused a ton and they would get to around 6.0 for less than 24 hours. They eventually went to comfort care and died, but was quite alert for a while.

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