Initial evaluation of the patient
-Check the skin turgor, skin dryness and any pale spots on the skin
-Check the eyes of the patient for dryness and paleness.
Check the patient for any edema especially on the lower limbs.. pressing using a finger is nice for checking pitting edema
check for mouth dryness.
patient’s presentation
The patient will presents with symptoms such as dizziness, headache, syncope, pallor ,pale,
On laboratory examination, the patient is found to have a low red blood cell count, low hemoglobin
Conditions that present with similar signs/symptoms
Apart from blood loss from gastrointestinal tract other conditions include:
-Anemia(megaloblastic, pernicious, sickle cell)
-Thalassemias(alpha and beta)
-Colon cancer
-porphyria
Treatment
The treatment modalities mainly focus on supplementing the blood volume.This will include blood transfusion and administration of blood products
Also treatment at ER will include oxygen therapy and fluids infusions
Other treatments include: use of Fe containing drugs, Vitamin B12 and alpha-epoietin to aid in formation of red blood cells.
Rationale for the various conditions
Severe blood loss form GIT tract in cases such as in peptic ulcer disease(PUD) ,colon cancer, severe hookworms infection results in blood loss hence lowering blood volume resulting to hypotension
Thalassemias occur as a result of malformation of the globulin chains(alpha or beta) of hemoglobin hence low hemoglobin levels and poor tissues oxygenation
Porphyrias are as a result of problems in the biosynthesis of heme contained in hemoglobin that binds to oxygen.This results in low hemoglobin and low hematocrit
Rationale for treatment
Use of blood transfusion is to replace the blood lost
Use of Fe, vitamin B12 and epoietin is to facilitate red cells formation and hence boost hematocrit levels.
All the best