You are a resident medical officer within the emergency department of a large me
ID: 86773 • Letter: Y
Question
You are a resident medical officer within the emergency department of a large metropolitan hospital when a 19-year old female (Tania) arrives in an ambulance after she has been involved in a water-skiing accident.
On arrival, Natasha appears pale with slightly bluish (cyanosed) lips and gums, and cool clammy skin. She also has a weak, rapid pulse, shallow irregular breathing, and appears disoriented. Her blood pressure is 90/50 mm/hg but slowly dropping. She has sustain a large, severe contusion to the left hypochondriac region and X-rays have confirmed that she has fractured the 9th and 10th ribs on the left side as a result of a violent impact injury. In addition, she has a very deep laceration to the posterior surface of the lower half of her right thigh.
When the ambulance arrived at the site of the incident, officers would have applied firm pressure to which arterial pulse site to prevent further blood loss from Tania’s injured leg? Explain the reason for your choice.
Natasha was a healthy 20 years old female with no past serious medical conditions. If there was now evidence of both haemorrhagic anaemia AND haemolytic anaemia in Natasha's blood film, discuss what may be the causes for each of these separate types of anaemia.
Explanation / Answer
The medical officer should firmly apply pressure on the Femoral arteries so as to stop the bleeding from Tania's leg. Femoral arteries are the pressure points for lower parts of the body.
Natasha suffered from haemorrhagic anaemia due to huge loss of blood from the deep laceration on the posterior surface of the lower half of her right thigh. Haemorrhagic anaemia is caused due to sudden and acute loss of blood from the body. Severe contusion to the left hypochondriac region lead to haemolytic anaemia which is caused due to the abnormal breakdown of RBCs (hemolysis).
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