Monday, February 11, 2013
I hope everyone is safe, warm, and healthy. The picture above is from the recent snowstorm in the Northeast, shown under GNU Free Documentation License, from Wikipedia.
Say a patient is pulled out of the vehicle above. She is brought to the emergency department, minimally responsive with a core temperature of 30 degrees. Her hematocrit is 36 (reference range 35.4-44.4). Her finger stick glucose is elevated to 200, and she is given insulin. From the extraction, she has some cuts and abrasions that continue to bleed. Despite a normal PT, PTT, and INR, you consider giving her clotting factors.
Challenge: Are you worried about the hematocrit? Tell me about the insulin. And would you give her some FFP?