Heme Onc Part 2- Hematology Emergencies

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🗓️ 5 October 2015

⏱️ 29 minutes

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Summary

This is part 2 of the Heme Onc Emergencies series. This episode will talk about common hematology emergencies that we see in the ED. Sickle cell disease will be its own episode but this episode will talk about the approach to anemia in the ED, as well as the approach to hemophilias, ITP and TTP. While you will see lots of anemic patients in the ED, the other diseases are rare but we have to be on the look out for them and know what to do.

Transcript

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0:00.0	Hi everyone, this is Steve Carroll, and welcome back to the Ambasid podcast.
0:05.0	This episode is part two of hemak emergencies and will be focusing on the hematology issues for this podcast.
0:11.3	Today we'll talk about a general approach to anemia, hemophilias, as well as the infamous purpros,
0:16.8	ITP, and TTP. Even though sickle cell disease is a hematologic issue, we frequently see in the
0:22.4	emergency department, we won't be talking about that today, because that topic deserves its own
0:26.7	episode. As always, this podcast doesn't represent the views of printing department of defense,
0:30.0	the US Army, and the Shawshacky M residency program. Let's talk first about anemia. You will see
0:35.3	many patients in the ED with varying degrees of anemia,
0:38.5	so it's important to have a good approach to this issue. Anemia is defined as a reduced volume
0:43.8	of red blood cells, and it can be either acute or chronic. Acute anemia in the ED is usually
0:49.8	caused by some sort of bleeding issue, while chronic anemia can be seen with chronic diseases,
0:55.0	such as renal failure, or be the result of a slow blood loss over a long period of time.
1:00.4	In general, anemia is defined as a hemoglobin of less than 14 in males and less than 12 in females,
1:07.0	but this number is highly dependent on age and the particular lab machine used to run the specimen.
1:11.6	The patient with anemia, who is not obviously bleeding from somewhere, usually presents the ED in one of two ways.
1:18.6	Patients may be sent in from a doctor's office due to critical anemia that is found on now patient CVC,
1:24.6	where the patient is experiencing symptoms of anemia. Mild anemia may also
1:29.3	be found in the routine workup of other issues that present to the ED where a CBC is performed.
1:34.6	In these patients, you may see vital sign abnormalities such as tachycardia or hypotension,
1:40.0	but this is usually the sign of a patient with an active and severe bleeding issue.
1:49.0	When you're doing a history on these patients, ask about symptoms such as weakness, fatigue, dips knee on exertion, or chest pain.
1:52.0	Keep in mind that if the patient is younger and the anemia has taken a long time to develop,
	...

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