Q82) A 35 y/o woman was admitted for Thrombotic thrombocytopenic purpura and was receiving plasmapheresis. She became agitated one evening and pulled off her right jugular catheter which has been her plasmapheresis access. Arrangements are being made to obtain an alternate access for plasmapheresis. On examination her B.P is 60/32., HR: 120, Tm: 102, RR 24. Physical examination revealed a remnant of jugular catheter that’s still bleeding. You remove the catheter immediately. The patient is now crashing and blood pressure is no longer recordable but palpable at 60. Next immediate step in managing this patient is :
A) Pericardiocentesis
B) Start IV fluids
C) Put patient in trendelenberg position
D) Needle thoracentesis
E) Portable chest x-ray
F) 2D echo
I think the answer is b
bbb
d
C
The most common problem is a drop in blood pressure, which can be experienced as faintness, dizziness, blurred vision, coldness, sweating or abdominal cramps. A drop in blood pressure is remedied by lowering the patient’s head, raising the legs and giving intravenous fluid.
immediate step : trendelenberg position
First give the fluids then the position
First the fluids then the positioning