Mr. Muhammad is a 20 year-old passenger on a bus that was in an accident on High

Question

Mr. Muhammad is a 20 year-old passenger on a bus that was in an accident on Highway 10. Upon arrival at the scene, paramedics make the following observations:

Right upper quadrant (abdominal) pain

Skin cyanotic; cool and clammy

Blood pressure 100/60 and falling, pulse 100

Paramedics start an IV to rapidly infuse a 0.9% sodium chloride solution (normal saline). They transport him to a small rural hospital where Mr. Muhammad’s blood pressure continues to fall and his cyanosis worsens. The physician begins infusing O negative packed red blood cells (PRBCs) and arranges transport by helicopter to a trauma center. She sends additional PRBC units in the helicopter for transfusion en route. After arrival at the trauma center, the following notes were added to Mr. Muhammad’s chart:

Abdomen firm and distended

Blood drawn for typing and cross matching; RBCs were shaped like crescent moons under microscope; packed A positive blood cells infused

Question 1: Mr. Muhammad was going into shock because of blood loss, so paramedics infused a saline solution. Why would this help?

Question 2: Why was the physician able to use O negative blood before the results of the blood type tests were obtained? Explain your answer.

Question 3: Mr. Muhammad’s blood type was determined to be A positive. What plasma antibodies (agglutinins) does he have and what type of blood can he receive?

Question 4: What would happen if doctors had infused type B PRBCs into Mr. Muhammad’s circulation?

Question 5: Describe the blood disorder Mr. Muhammad may have. What are some effects (symptoms, complications) of this disorder?

Mr. Muhammad is found to be losing huge amounts of water in the urine and the volume lost is being routinely replaced (via IV line). Blood and urine tests are positive for glucose and ketones. Mr. Muhammad’s condition continues to deteriorate, so he is prepared for surgery, which reveals a lacerated liver. The laceration is repaired and Mr. Muhammad’s vital signs stabilize.

Question 6: What would you say Mr. Muhammad’s hormonal problem is and what do you think caused it? Explain your answer.

Explanation / Answer

A) During blood loss, saline solution maintains blood volume, increases blood circulation to organs, maintains bolld pressure as well as decreases bleeding.

B) O negative blood type is called as universal donor. This blood type is usually given during emergency situations as it do not have any antigens so no Antibody - Antigen interaction will occur in recepient's blood.

C) A positive blood have B antibodies and A antigen so he can recieve A+, A-, O+ and O-

D) As the patient has A+ blood group so if he receives B type blood then Antibody - Antigen interaction will occur in his blood. The reason is A+ blood has A antigens whereas B blood types contains A antibody so in the receipient's blood A antigen (from A+ blood) and A antibody (from B blood type) will interact reulting in the agglutination which can be fatal.

E) As the RBCs were crescent shaped , the patient is suffering from Sickle Cell anemia. this disease is characterized by improper oxygen transport, clumping of RBC in the organs, RBCs number fall causing anemia, higher chance of infection and stroke

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