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Yusuf

๐Ÿ‘ค Speaker
135 total appearances

Appearances Over Time

Podcast Appearances

The Clinical Problem Solvers
Episode 459 โ€“ Schema Episode: Coagulopathy

Platelet count, 500,000.

The Clinical Problem Solvers
Episode 459 โ€“ Schema Episode: Coagulopathy

His CPK, 7,000.

The Clinical Problem Solvers
Episode 459 โ€“ Schema Episode: Coagulopathy

Creatinine, normal.

The Clinical Problem Solvers
Episode 459 โ€“ Schema Episode: Coagulopathy

Electrolytes, normal.

The Clinical Problem Solvers
Episode 459 โ€“ Schema Episode: Coagulopathy

Surgery, they come and see him, take him to OR immediately.

The Clinical Problem Solvers
Episode 459 โ€“ Schema Episode: Coagulopathy

They perform a fasciotomy.

The Clinical Problem Solvers
Episode 459 โ€“ Schema Episode: Coagulopathy

And while performing the fasciotomy, the patient has severe oozing of blood inside the OR.

The Clinical Problem Solvers
Episode 459 โ€“ Schema Episode: Coagulopathy

And in the OR, they review the labs, and he actually has a PT that is normal and a PTT that is markedly elevated at 80.

The Clinical Problem Solvers
Episode 459 โ€“ Schema Episode: Coagulopathy

So they actually consult hematology from inside the OR,

The Clinical Problem Solvers
Episode 459 โ€“ Schema Episode: Coagulopathy

And in the OR, they call him and he was like, okay, let's do some fresh frozen plasma, some tranexamic acid, some prothrombin complex, and they complete the OR safely.

The Clinical Problem Solvers
Episode 459 โ€“ Schema Episode: Coagulopathy

So I'm going to stop there and throw it to Maddy.

The Clinical Problem Solvers
Episode 459 โ€“ Schema Episode: Coagulopathy

Even your dog is scared of the coagulation cascade.

The Clinical Problem Solvers
Episode 459 โ€“ Schema Episode: Coagulopathy

Wow.

The Clinical Problem Solvers
Episode 459 โ€“ Schema Episode: Coagulopathy

Your discussion is like an expert discussion.

The Clinical Problem Solvers
Episode 459 โ€“ Schema Episode: Coagulopathy

So you all are doing amazing.

The Clinical Problem Solvers
Episode 459 โ€“ Schema Episode: Coagulopathy

So the patient did not have a history of bleeding prior to these events, has had procedures in the past that went well.

The Clinical Problem Solvers
Episode 459 โ€“ Schema Episode: Coagulopathy

And hematology recommended sending the work up, like you all said.

The Clinical Problem Solvers
Episode 459 โ€“ Schema Episode: Coagulopathy

So a mixing study

The Clinical Problem Solvers
Episode 459 โ€“ Schema Episode: Coagulopathy

fibrinogen level, factor VIII, V, X, XIII, and von Willebrand studies, because there is a version of von Willebrand disease that causes a factor VIII deficiency, and I'll talk about that shortly after we finish the discussion.

The Clinical Problem Solvers
Episode 459 โ€“ Schema Episode: Coagulopathy

So his factor VIII level was extremely low, almost undetectable.