Your patient is a 23-year-old female who is 6 hours postpartum after a traumatic delivery resulting in a massive blood transfusion. She is to be transferred from a community hospital to a specialty hospital for further care. She is unconscious and intubated, with a number of intravenous lines. Your physical examination reveals a purpuric rash over the chest and abdomen and mottling of the fingers and toes and all of the venous access sites are oozing blood. In addition, auscultation of the lung fields reveals rales to the dependent regions. HR = 112, BP = 82/60, RR = 12 via ventilator. Which of the following best describes the patient's condition and treatment needs, in addition to continued ventilation and fluid administration?

Question

Quizplus · Accepted Answer

The patient's clinical presentation is consistent with disseminated intravascular coagulation (DIC) which is a condition in which blood clots form throughout the body, leading to multiple organ dysfunction and bleeding. The purpuric rash and oozing from venous access sites are indicative of bleeding under the skin and bleeding from mucous membranes, respectively. The mottling of the fingers and toes is a sign of poor perfusion. The patient has also received a massive blood transfusion, which can further exacerbate DIC. Fresh frozen plasma and platelet administration are necessary to replenish coagulation factors and correct the underlying coagulopathy. Type-specific or cross-matched blood may also be needed, but the patient's blood type is not provided in the scenario.

Your Patient Is a 23-Year-Old Female Who Is 6 Hours