It is 4am and you are peacefully dreaming about the educational opportunities at #BBTS2021 when you are awoken by the neurosurgical SpR on-call. They would like advice around product support for a patient they wish to take to theatre for an emergency decompressive craniectomy.
The patient is a 34 year old lady who presented to A&E with a severe headache and has subsequently dropped her GCS to 9/15. CT head has demonstrated a large intracranial bleed with mass effect and midline shift. FBC on admission:
- Hb 151
- WCC 5.8
- Plt 25
They are planning transfer to theatre imminently, and the procedure cannot be safely delayed.
Is there any other information you require pre-operatively?
What advice would you give to support the platelet count?
Are there any other investigations which may be helpful?
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Please note – all cases on TeamHaem are entirely fictional to protect patient confidentiality.TeamHaem are not a position of authority. It is an educational platform to allow discussion and learning.
TeamHaem are not a position of authority. It is an educational platform to allow discussion and learning.