Lectures

Cases That Kept Me Up At Night: Case #1

Case #1:Unintentional Harm

• 27 year old female
• 1st pregnancy
  • RhIg given at 28 weeks gestation
  • Uneventful delivery
  • Infant petechiae & thrombocytopenia
    • Alloimmune thrombocytopenia
      • HPA-1 antibody detected
      • Platelet transfusion therapy

Cases That Kept Me Up At Night: Case #2

Case #2:Cutting Corners in the OR

• Patient N = 83y male scheduled for CABG x 4
• T&C for 2 RBC ordered one day prior to surgery
  • O positive with negative antibody screen
• CVOR #1 ordered 2U RBC for Patient N
  • Units sent to CVOR via tube system
• CVOR#2 ordered 2U RBC for patient H
  • B positive
  • Units sent to CVOR via tube system
  • 2U RBC retrieved from tube station & taken CVOR#1
  • Blood bag label not checked
    
    

Case 2:Twas the Night After Christmas

Cases That Kept Me Up At Night: Case #3

Case #3:Doc I Have a Black Cloud Over My Head

• 80y male
• Heterozygous Factor V Leiden
• Multiple episodes of DVT & PE
• Inferior vena cava filter
• Coumadin therapy
• Multiple episodes of GI bleeding
  • Nov 2007 - 2 RBC, 5 FFP
  • Dec 2008 – 15 RBC, 10 plasma, 2 platelet

Case 3:Doc I have a black cloud over my head

Cases That Kept Me Up At Night: Case #4

Case #4:Self Destruction

• 70y female with past medical history of multiple sclerosis x 40y, mitral valve prolapse & DVT
• Presented with dizziness, SOA, palpitations, nausea & UTI
• Hb 7.7 (13.3 two months earlier)
• Hb 6.3 day after admission
• 2U RBC ordered

Cases That Kept Me Up At Night: Case #5

Case #5:A Very Expensive Retirement

• 63y male who was previously healthy and recently retired
• Acute onset of pain in right thigh & left calf after stretching exercises
• Pain worsened after mowing grass
  • Right forearm involvement
  • Right upper arm ecchymosis
  • Hematuria