Select the term defined as the replacement of one or more blood volumes within 24 hours whether in an infant or in an adult patient. Hemorrhagic shock Normovolemic shock Massive transfusion Exchange transfusion
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Which term is related to blood?
Jennifer S.
A 20 year old male was working second shift when a 10-ton forklift fell and pinned him face down. He was trapped for 20 minutes. Paramedics at the scene started intravenous fluids. His vitals at the scene were heart rate 120 bpm (normal 60-100 bpm), blood pressure 90/70 mm Hg (normal 120/80 mm Hg) and respirations 46 breaths/min (normal 12-18 breaths/min). In the ambulance he continued to be tachycardic and he reported that his heart was "pounding in his chest". He was restless, pale, cool and damp. His vitals in the ambulance were heart rate 138bpm and blood pressure 88/70 mm Hg. Peripheral pulses and bowel sounds were absent. Intravenous fluids were continued and he was diagnosed as being in hypovolemic shock. At the hospital his initial hemoglobin was 9 g/dl (normal 12.4-14.9 gm/dl ) and hematocrit was 30% (normal 42%-54%). He was put oxygen at 3L/min by nasal cannula and a urinary catheter was inserted. Urine production was very low. After a transfusion of 2 units of red blood cells, his heart rate was 110 beat/min, blood pressure 102/70, and respirations 28 breaths/min. He complained of severe abdominal pain and abdominal lavage revealed excess peritoneal fluid containing red blood cells. He was then taken to the operating room for emergency treatment of a ruptured spleen. During the surgery he needed 6 more units (3 liters) of red blood cells. After the surgery he appeared to stabilize with vitals of heart rate 104, blood pressure 106/70, and respirations 26 breaths/min. He continued to recover over the next few days, during which time he had low urine output.
Adi S.
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