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Management of Jehovah's Witness patient in ICU Clarify which products may be used - Discuss
periodically check platelets ... 20% Treat any bleeding ... procedural control of bleeding ... #patient #ICU #CriticalCare
Idiopathic Thrombocytopenic Purpura Clinical: • Gingival • Menorrhagia • GI bleeding • Intracranial
Menorrhagia • GI bleeding ... children) • Platelets ... only for severe bleeding ... extremely low platelet
Indications for Transfusion Packed RBCs • Hgb <7 g/dL or hematocrit <21% in a patient with uncompromised
hemoglobinopathy Platelets ... • < 30,000 and bleeding ... postoperative bleeding ... < 100,000 and bleeding ... Platelet transfusions
Inherited Qualitative Platelet Defects Bernard-Soulier Syndrome • Defect of adhesion due to a lack of GP Ib/IX/V
Inherited Qualitative Platelet ... Single isolated platelets ... without platelet ... failure Grey Platelet ... • Absence of platelet
Thresholds for Transfusion of Platelets in Adults Major surgery or invasive procedure, no active bleeding - ≤
Transfusion of Platelets ... procedure, no active bleeding ... neurosurgery, no active bleeding ... Surgery with active bleeding ... #Management #Platelets
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 Bleeding and Bruising - Differential Diagnosis Algorithm • Vascular System Defect - Congenital vs Acquired •
Bleeding and Bruising ... vs Acquired • Platelet ... vs Acquired #Bleeding
Platelet disorders and Aggregometry Glanzmann Thrombasthenia • Defective aggregation to all agonists except ristocetin • Normal platelet,
Platelet disorders ... ristocetin • Normal platelet ... count and platelet ... • Platelet flow ... Usually normal platelet
Thrombocytosis - Differential Diagnosis Platelet Count > 450 Reactive: • Anemia/blood loss (Fe deficiency) • Infection/Sepsis • Non-infectious
Differential Diagnosis Platelet ... Diagnosis #causes #Platelets
Forrest Classification for Peptic Ulcer Bleeding Rebleeding risks are without endoscopic intervention 1a - Spurting Bleed - 60-100%
Bleed - 60-100% Re-bleeding ... Bleed - 50% Re-bleeding ... IIa - Non-Bleeding ... Clot - 20-30% Re-bleeding ... Peptic #Ulcer #Bleeding
Approach to Leukocytosis - Differential Diagnosis Algorithm Features of hematologic malignancy: • Symptoms: B-symptoms, bruising/bleeding, fatigue/weakness, immunosuppression
B-symptoms, bruising/bleeding ... anemia, ↑ MCV, ↑/↓ platelets
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