Hypovolemic shock and blood transfusion intervention - Essay Example

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This paper will analyse the administration of packed red cells transfusion in a patient with hypovolaemic shock arising from severe haemetemesis. The identity of the patient has been changed to Mr. Z to ensure anonymity and confidentiality …
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Hypovolemic shock and blood transfusion intervention
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Download file to see previous pages This research presented typical features of hypovolaemic shock, primarily developing from chronic alcoholism. The patient earlier episodes of epigastric pain and upper GI bleeds and was treated for the same by antiemetic drugs and antacids. Following that episode he was advised against drinking and smoking. In this event, Mr. Z developed nausea 48 hours before the haemetemesis. During the haemetemesis episode he vomited blood 5 times, containing blood coffee brown in colour and from the upper GI. In this case, the rationale for giving blood was that the patient’s haemoglobin levels were only slightly above normal, the blood loss was severe, and the patient’s condition was perceived to be serious. The physicians in this case had to make a close decision, as if the symptoms and the vital sign (especially blood pressure) could be managed effectively, blood transfusion was not needed. The criteria for blood transfusion are made based on general criteria and not the management or care setting for the particular patient. For example, if the patient is managed in the ICU, there is oxygen and respiration is taken care of and hence, anaemia may not be a serious issue that the patient has to cope with. Hence, the care settings have an important role to play. The most important criteria for transfusing blood for an ICU patient are whether the patient is hemodynamically stable or not. If the patient cannot be maintained properly in a hemodynamic state (even though the blood loss was minimum), then blood transfusion is needed. Haemoglobin is critical in ensuring oxygen supply to the vital organs and the tissues of the body. However, if the patient can be maintained hemodynamically stable (even though the blood loss was severe) and the haemoglobin levels is below 7 g/dl, the vital signs are seriously affected, then the patient has to be suggested for blood transfusion. In this case, it would be likely that blood transfusion was given as a precautionary measure although in the current care settings, stability of the vital signs and haemoglobin level it would not be necessary. Besides, the fact that the patient was currently in the ICU was not taken into consideration, and it is important that this fact be taken into consideration. The blood pack has been administered slowly over 3 hour duration (as per the mentioned in the case), and any risk of adverse effects were monitored. Though no urticaria and erythema were noticed, there has been a slight improvement in the patient’s blood pressure levels, APTT, Haemoglobin levels, heart rate and respiratory rate. However, there is not much improvement in other important components such as blood pressure, pulse, breathes rate and haemoglobin (Veenema, 2007). Ethically and legally, consent was obtained orally and carefully documented. The patient should be competent to give consent and only if the patient’s condition is such he is in a position to give consent, should consent be taken. There was also a need to ensure ...Download file to see next pagesRead More
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