A question for any doctors or medical types - The DIS Discussion Forums

chirurgeon · 11-20-2009, 01:39 PM

This is a strange question, but it is bugging me. On the Mentalist last night, a character died due to blood loss. He was shot and then operated on and in ICU and another character said the injured person was going to die due to blood loss. I don't understand this. I know TV isn't real but I thought SOME shows tried to do things right. Just curious, would a person die due to massive blood loss if they were taken to a hospital and had transfusions? And if this is true would this person be conscious.

These are the kind of questions that bug me.

TIA,
Kim

bumbershoot · 11-20-2009, 01:41 PM

If a person keeps on bleeding, transfusions won't help.

Disney Doll · 11-20-2009, 01:49 PM

Sometimes you can't put it in as fast as it is coming out.

Years ago, I cared for a gentleman who exsanguinated (bled to death) from a blood vessel in his abdominal cavity that ruptured. he literally died within about 10 miutes, despite our best efforts to stop the bleeding and pump blood into him as fast as we could.

Very sad...

laurie31 · 11-20-2009, 03:09 PM

I'm a visual person, so here's a visual example

Imagine you have a gallon milk jug, filled with water. It gets a hole in the bottom. You're trying to keep it full by pouring more water in the top, while someone else tries to patch the hole. If the hole is small enough, and you can pour fast enough, AND the person who's fixing the hole is talented, then you can manage to keep your gallon jug full of water, despite the hole.

However, imagine if the entire bottom of the jug is gone. No matter how fast you pour more water in, no matter how skilled the person trying to fix the hole is, you are not going to be able to keep the jug from emptying.

Bleeding to death is like that. Nurses are infusing blood products - packed red cells, platelets, etc - as rapidly as possible, surgeons are trying to find and repair the damage, but sometimes it's just not possible, even in 2009.

Whether or not the person is conscious until the end is near depends on why they're bleeding in the first place, but yes, it's possible.

Golf4food · 11-20-2009, 03:12 PM

"The human body can be drained of blood in 8.6 seconds given adequate vacuuming systems." - River Tam, Firefly

Judy from Boise · 11-20-2009, 06:37 PM

I think I get your point that it seems if someone has been stabilized, in the ICU, and conscious......that dying from blood loss is not exactly accurate.....it would no longer be the proximal cause of death. More likely they would die of a complication of massive blood loss.

scottishduffy · 11-20-2009, 07:12 PM

Yep, It happens. During my tenure as an ICU nurse I saw it happen quite a few times.

The closest i can think to your scenario (conscious patient in ICU bleeding) would be the liver patients. I saw them bleed out several times. We tried and tried to give blood and products but sometimes there is just nothing you can do.

Now I work in the OR and for items such as a ruptured Aorta patients can die in a matter of minutes. There is no way you can get blood in fast enough in that scenario.

Like someone else said before, a small hole in a milk jug we can cover. Yet when you saw off the bottom of the jug it is impossible to ever attempt to fill something without a bottom.

phorsenuf · 11-20-2009, 07:17 PM

So if someone is bleeding internally and someone is pumping it in, where does all the blood go?

scottishduffy · 11-20-2009, 07:25 PM

Your belly can hold a LOT of fluid.

If someone has a GI bleed (common reason I saw this), it will pass through thr GI tract and come out the back end. It will accumulate some in the belly but quite a bit will come out.

With the Aortic ruptures it just stays inside, around the abdomen.

minkydog · 11-20-2009, 11:57 PM

My dad bled out in the ICU. He was very very sick, had undergone an MI, an attempted stent which resulted in a code, then a quad bypass which left him in A-fib. He never had a chance. He was alert and oriented when he started bleeding. He complained of a stomach ache just before started bleeding from everywhere. He had DIC(a blood clotting problem that can happen do someone who has experience severe trauma, childbirth, surgery, and other serious stuff.) As someone else said, they were pouring blood in and he was pouring blood out. It was really terrible. Thankfully, it didn't last too long. His heart couldn't take it anymore and they let him go.

laurie31 · 11-21-2009, 12:29 AM

Quote:

Originally Posted by minkydog

My dad bled out in the ICU. He was very very sick, had undergone an MI, an attempted stent which resulted in a code, then a quad bypass which left him in A-fib. He never had a chance. He was alert and oriented when he started bleeding. He complained of a stomach ache just before started bleeding from everywhere. He had DIC(a blood clotting problem that can happen do someone who has experience severe trauma, childbirth, surgery, and other serious stuff.) As someone else said, they were pouring blood in and he was pouring blood out. It was really terrible. Thankfully, it didn't last too long. His heart couldn't take it anymore and they let him go.

11-20-2009, 01:39 PM	#1
chirurgeon I am a delicate flower and need my sleep Join Date: Jan 2000 Location: Pittsburgh, PA USA Posts: 3,356	A question for any doctors or medical types This is a strange question, but it is bugging me. On the Mentalist last night, a character died due to blood loss. He was shot and then operated on and in ICU and another character said the injured person was going to die due to blood loss. I don't understand this. I know TV isn't real but I thought SOME shows tried to do things right. Just curious, would a person die due to massive blood loss if they were taken to a hospital and had transfusions? And if this is true would this person be conscious. These are the kind of questions that bug me. TIA, Kim __________________ CBR 04/00, YC 12/02, ASSp 06/05, AKL/BWI 12/06, ASSPo/POFQ 06/07, POFQ/AKL 12/08, Podcast Cruise 05/09, Dolphin/POP DAP/TSM 2.0 12/09, POFQ/BCV 04/10, Podcast Cruise 2.0 12/10

11-20-2009, 01:41 PM	#2
bumbershoot DIS Veteran Join Date: Mar 2007 Location: Tacoma WA Posts: 19,272	If a person keeps on bleeding, transfusions won't help. __________________ -molly 13 DLR trip reports of various kinds found through this link *prepretrip report for WDW*

11-20-2009, 01:49 PM	#3
Disney Doll DIS Security Matron Join Date: Nov 2000 Location: Trumbull,CT,USA Posts: 22,336	Sometimes you can't put it in as fast as it is coming out. Years ago, I cared for a gentleman who exsanguinated (bled to death) from a blood vessel in his abdominal cavity that ruptured. he literally died within about 10 miutes, despite our best efforts to stop the bleeding and pump blood into him as fast as we could. Very sad... __________________ Disney Doll Prepare your child for the path, not the path for your child. Stop telling your God how big the storm is. Instead, tell the storm how big your God is. It's time to put on your big girl panties and deal with it! He is your friend, your partner, your defender, your dog. You are his life, his love, his leader. He will be yours, faithful and true, to the last beat of his heart. You owe it to him to be worthy of such devotion. ~~In loving memory of Teddy~~1994-2007~~

11-20-2009, 03:09 PM	#4
laurie31 Once had a roommate in college who had 17 boyfriends! Unplugs the internet with her toes I refuse to eat in a restaurant that also sells bait or jail bonds Join Date: Apr 2003 Location: Leeds, Alabama Posts: 4,085	I'm a visual person, so here's a visual example Imagine you have a gallon milk jug, filled with water. It gets a hole in the bottom. You're trying to keep it full by pouring more water in the top, while someone else tries to patch the hole. If the hole is small enough, and you can pour fast enough, AND the person who's fixing the hole is talented, then you can manage to keep your gallon jug full of water, despite the hole. However, imagine if the entire bottom of the jug is gone. No matter how fast you pour more water in, no matter how skilled the person trying to fix the hole is, you are not going to be able to keep the jug from emptying. Bleeding to death is like that. Nurses are infusing blood products - packed red cells, platelets, etc - as rapidly as possible, surgeons are trying to find and repair the damage, but sometimes it's just not possible, even in 2009. Whether or not the person is conscious until the end is near depends on why they're bleeding in the first place, but yes, it's possible. __________________

11-20-2009, 03:12 PM	#5
Golf4food Mouseketeer Male pirate last time I checked... yep, still male Tazicket will always be my sexy penguin Join Date: Feb 2005 Location: 161 miles from the TTC Posts: 5,340	"The human body can be drained of blood in 8.6 seconds given adequate vacuuming systems." - River Tam, Firefly __________________ September 09 DxDP Dining Report - click here September 2009 - ASMu & DxDP - report link above December 2008 - POR September 2008 - short birthday trip @ ASMovies June 2007 - One day surprise park hopping extravaganza for DW December 2006 - CBR March 2005 - CBR Many visits before getting married... Check out our photos from Disney World on Flickr!

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11-20-2009, 06:37 PM	#6
Judy from Boise Watch out – might take away your birthday Not superfluous in the least! DIS World Traveller Join Date: Aug 1999 Location: Beautiful Boise,Idaho Posts: 8,436	I think I get your point that it seems if someone has been stabilized, in the ICU, and conscious......that dying from blood loss is not exactly accurate.....it would no longer be the proximal cause of death. More likely they would die of a complication of massive blood loss.

11-20-2009, 07:12 PM	#7
scottishduffy I was walking around and providing my own musical theme song in the chord of F flat "Yes ma'am. I am trying to develop an amazing pain tolerance and thought this would be an awesome way to start." Join Date: Aug 2007 Posts: 987	Yep, It happens. During my tenure as an ICU nurse I saw it happen quite a few times. The closest i can think to your scenario (conscious patient in ICU bleeding) would be the liver patients. I saw them bleed out several times. We tried and tried to give blood and products but sometimes there is just nothing you can do. Now I work in the OR and for items such as a ruptured Aorta patients can die in a matter of minutes. There is no way you can get blood in fast enough in that scenario. Like someone else said before, a small hole in a milk jug we can cover. Yet when you saw off the bottom of the jug it is impossible to ever attempt to fill something without a bottom. __________________

11-20-2009, 07:17 PM	#8
phorsenuf New Rule: The first person to reply on any thread needs to quote the OP. That way when someone does the delete of nevermind edit we know what was there. Now Repeat after me. Join Date: Feb 2003 Location: NH and soon Palm Harbor, FL Posts: 12,645	So if someone is bleeding internally and someone is pumping it in, where does all the blood go? __________________ IS TOTALLY DISGUSTED ---------> Parents owe their children two things.......Roots and Wings. God gave us children so we would have roses in December.

11-20-2009, 07:25 PM	#9
scottishduffy I was walking around and providing my own musical theme song in the chord of F flat "Yes ma'am. I am trying to develop an amazing pain tolerance and thought this would be an awesome way to start." Join Date: Aug 2007 Posts: 987	Your belly can hold a LOT of fluid. If someone has a GI bleed (common reason I saw this), it will pass through thr GI tract and come out the back end. It will accumulate some in the belly but quite a bit will come out. With the Aortic ruptures it just stays inside, around the abdomen. __________________

11-20-2009, 11:57 PM	#10
minkydog DIS Cast Member hey! I've got two college degrees and a steady job. if I wanna watch mindless TV, so what? DIS Official Rum Taster I used to be in the all-natural camp. Join Date: Dec 2004 Location: GA Posts: 8,710	My dad bled out in the ICU. He was very very sick, had undergone an MI, an attempted stent which resulted in a code, then a quad bypass which left him in A-fib. He never had a chance. He was alert and oriented when he started bleeding. He complained of a stomach ache just before started bleeding from everywhere. He had DIC(a blood clotting problem that can happen do someone who has experience severe trauma, childbirth, surgery, and other serious stuff.) As someone else said, they were pouring blood in and he was pouring blood out. It was really terrible. Thankfully, it didn't last too long. His heart couldn't take it anymore and they let him go. __________________ Never underestimate the determination of the mother with a handicapped child

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