Monday, November 4, 2013
In the CT scanner, he spikes a temperature and becomes more hypotensive. He is started on vancomycin and piperacillin-tazobactam. His blood pressures continue to plummet and the CT scan is aborted. He is taken emergently to the operating room for an exploratory laparotomy. The anesthesiologist continues to fluid resuscitate the patient, giving more blood products, fresh frozen plasma, and platelets. The patient is started on a dopamine drip. A fibrinogen panel comes back low and cryoglobulin is administered. At the end of the case, dark red-brown urine is noted in the Foley catheter. Initial placement of the Foley catheter showed concentrated yellow urine. At this time, the hematology lab calls and says that when they spun down the patient's blood, the plasma was light pink. A critical lab value of potassium 6.2 is also noted.
Challenge: What happened?
Bonus Question: What's shown in the picture above?
Image shown under GNU Free Documentation License, from Wikipedia.