Second Case August 4, 2013 – Subsequent Case Management

Click this link to download the subsequent case file from box.net:https://app.box.com/s/okn1r7mwnuki679apu0u

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This is a case involving an 81 year-old male patient s/p fall with forehead abrasion and contusion. There are no neurologic deficits. A CT scan in the ER (no formal reading found in chart) is stated in ER records to have areas suspicious for tiny hemorrhagic contusions. If data is missing, you can assume that it was not documented in the chart or is reported to be unremarkable or negative.

The patient was hospitalized 7.1 days and was transfused six platelet pheresis units at 8:12, 8:23, 13:35, 15:00, 22:51 and 24:18 hours post-admission. The transfusion start and stop times were not recorded in 4 of 6 transfusions and consequently the start time is listed for only 2 units.

How best should this patient have been managed?

The Second Case Management Commentary will be posted August 9th.