Lois & Clark Forums Forums Fan Fiction Fanfic Related FFQ: More medical questions...

More blood loss related questions, quite a few of them, actually.

Let's say that a person has lost 3 units of blood and will die unless they receive a blood transfusion. Having already given the patient intravenous fluids to replace the lost blood volume, about how long would you say the patient has to live without receiving a blood transfusion?

Also, what symptoms would this person go through? Would they be unconscious? Is it correct that they'd have trouble breathing and have low blood pressure? If conscious, would the patient vomit, have headaches, be sleepy, weak?

What if a blood transfusion was possible, but only at a unit at a time, say over a 48 hour period? Would this be enough to save the patient's life?

Okay, I think that's all. If anyone can answer these questions, I'd be so grateful! Thanks.

I'm not a doctor - but you really want to check out some books on critical-care and emergency nursing.

EMTs and ER staff refer to the 'Golden Hour' The time you have to stop blood loss and stabilize the patient. In the event of massive blood loss - first get the blood pressure up by giving IV fluid (Blood transfusions are NOT given in the field). Then make sure enough oxygen is getting to the brain.

Symptoms will include low body temperature, weakness, confusion, unconsciousness.

Once the Golden hour is past - shock will be irreversable and the patient dies, not immediately, but the organ damage is too great for recovery.

Hi,

This is my personal experience.

I had transfusion 2 times.

1. My first time a went to the hospital for an infection and all the blood test they found I had 30-40 of blood level (hemoglobin). They put 3 transfusions.
I only remember being very tire and weak.


2. Second experience was on my surgery I remember waking up in the middle of the surgery hearing 'she losing too much blood' they recline my head more and try to take some more blood sample on my neck vein to check type. After the surgery they put 2 more pint of blood for a total of 4 pint.


I don't think is will help you.

MAF

As an ICU nurse in my previous life, transfuse 1 mL of packed red blood cells per 1 mL of blood loss. Give 3 mL IV fluids for every 1 cc blood loss. I've never given whole blood. Always packed red blood cells (PRBC's), fresh frozen plasma (FFP) or platelets.

Usually a transfusion depends on where a patient started with their Hemoglobin and hematocrit. The critical point of transfusing a patient is around a hemoglobin of 7 (normal 12-16) or less, hematocrit of 20 (normal 39-48). It depends too on where the patient started ands on anticipated blood loss as in a trauma or surgery. Some people walk around with an H&H of 7&22.

People with low H&H's are tired, weak, pale and in the incidence of trauma they act hazy and disoriented, just to name a few symptoms. Some people even get short of breath. Blood carries oxygen to the brain s if the brain is low on oxygen, brain cells don't work well. Here in my hospital we are very cautious about giving blood and only do it when absolutely necessary because of the risk factors involved; HIV, Hepatitis, transfusion reactions. Though the blood is thoroughly screened for infectious diseases, you cannot be 100% always.

Anyway, does this help?

~Sheila

Sheila got in while I was typing:

According to my books:
The symptoms of hypovolemic shock (shock from blood loss) depends on a number of things, including the volume and severity of blood volume loss, age and health of the patient and the patient's ability to compensate (muster the body's defenses by increasing heart-rate, and constricting capillaries to force the blood to remain in the center of the body.)

Symptoms at this time will include cold, clammy skin, paleness, thirst, fast heart-rate, fast breathing and possible changes in blood pressure (not a drop in blood pressure necessarily but a narrowing in the difference in the top and bottom numbers), and delayed capillary refill. Also the kidneys begin to slow down. The patient's level of consciousness changes (he becomes confused, restless, anxious.)

As shock progresses lack of oxygen to the body causes the heart rate to increase and become irregular. The kidneys shut down. When the kidneys shut down the lack of oxygen has already caused serious damage to the organs and organs begin to shut down - once this begins it is difficult if not impossible to reverse. There is a 90-100% morality rate when only three body systems fail.

In shock, time is of the essence. It's not called the Golden Hour for nothing.

Now the above is oversimplified. When an EMT or emergency worker comes on the scene - ABCD
Airway (clear airway if necessary, maintaining proper spinal alignment)
Breathing (supplemental oxygen as needed)
Circulation (control bleeding, increase blood volume)
Disability (level of Consciousness)
OR
Defibrillation (in cardiac arrest)

The problems above must be dealt with immediately.

Blood transfusions are NOT a field operation. In the field normal saline, lactated Ringer's or other solutions will be given.
A patient with major blood loss that needs blood quickly will be given O-negative Packed Red Blood Cells (PRBC) until properly typed and matched blood can be found.

(If your local library has is, I suggest Schumancher & Chernecky's 'Critical Care & Emergency Nursing'. Personally, I think this book is a must for anyone writing Action-Adventure or ends up with hurt characters. Me? I collect medical books.)

Thanks for taking the time to answer my questions, everyone! Your help is greatly appreciated.