Educational prescription

[GiJoe]

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I'm running all over the place like a chicken with its head cut off....

my wonderful attending gave me an education prescription ...i dont know if any of you folks have to put up with this $hit but he's asked me

"what level of Hb will make a patient lethargic (i.e. have mental status changes?)"


for the love of God someone please help me with this crap

 

[Gibby Haynes]

I'm running all over the place like a chicken with its head cut off....

my wonderful attending gave me an education prescription ...i dont know if any of you folks have to put up with this $hit but he's asked me

"what level of Hb will make a patient lethargic (i.e. have mental status changes?)"


for the love of God someone please help me with this crap

Thats kind of a ****ty question in my opinion. In my limited experience it will probably depend on whether the anemia is acute or chronic and what range they normally live in. I've seen a few patients who had Hb of 6 and said they felt fine. There body has adjusted after years of being anemic. On the flip side you will see someone who normally lives in the 12-13 range and the Hb suddenly drops in the 7-8 range and they become very symptomatic. If somene can come up with the definitive number that at X Hb you have X symptom than I stand corrected.

 

[GiJoe]

Thats kind of a ****ty question in my opinion. In my limited experience it will probably depend on whether the anemia is acute or chronic and what range they normally live in. I've seen a few patients who had Hb of 6 and said they felt fine. There body has adjusted after years of being anemic. On the flip side you will see someone who normally lives in the 12-13 range and the Hb suddenly drops in the 7-8 range and they become very symptomatic. If somene can come up with the definitive number that at X Hb you have X symptom than I stand corrected.

yea i figured that'd be the case but I have yet to find ANY article that comes even remotely close to talking about that. Anyone know where I can find one???

 

[Pilot]

Had a guy two months ago on my service who presented with a Hgb of 2.7. When I saw him in the E.D. for admission (after 6 units transfused), he asked me for a cup of coffee. I politely declined - 2 days later he was on a vent with multi-organ failure, and died 5 weeks later.

 

[Skialta]

There was a study I believe it was called the CRIT study or something like that. It looked at mortality related to Hbg in Jeehova's Witness' as related to trauma and surgical cases. I know the cutoff is about 6 for no cardiac/organ effects. I agree with the above posters. Hope it helps.

 

[Cristagali]

just say 6-7 and no one can argue with you. GL 👍