Blood Transfusions

After this you should appreciate when you go to the hospital.

This morning, a little girl with malaria started seizing. When I opened the chart to write the orders for the phenobarbital, I noticed that some lab results had come back. Her hemoglobin was 3.5. That should cause a panic inside of you....that is a dangerously low level of blood cells. Especially in a child who is continuing to drop from the malaria. The lab was so concerned they had someone run over with the results and told one of the nurses. She just wrote it in the chart and didn't tell anyone. So I ran the order over to the lab for the transfusion. But it still took 1 hour to get the blood.

Transfusions are risky here for children. Not so much for the risk of disease transmission. But because of how hard it is to control the rate. In modern hospitals, IVs have computers attached that you can program the rate into. Here calculate how many drops a minute you want, adjust the dial, count how many drops, adjust it again, count, etc. There have been a few children who have died from fluid overload from getting their transfusions to quickly (over 1 hour rather than 4!).

So anyway, this little girl is still in a coma, is urinating blood, receiving her blood transfusion, but no more convulsions and her fever has come down a little bit. And so we wait and hope and pray she comes out of the coma.