Question

A CST is assisting the surgeon on the midline closure of an episiotomy. The surgeon says, "Something's wrong, but I can't identify it." The CST replies, "I'm worried also. Do you think she might have DIC (disseminated intravascular coagulopathy)?" The surgeon responds, "Why do you think that?" and the CST says, "I've seen this before, and the blood doesn't look right. I placed some of the patient's blood in a plain test tube 7 minutes ago, and no clot has formed." The surgeon has the circulator page the attending obstetrician to the room and alerts the anesthesia care provider. The patient became slightly hypotensive, but the quick response of the OR team averted any serious complications. The patient was discharged several days later without further complications. What observation did the CST make that helped the patient in this case? Discuss whether the CSTs response was appropriate in this situation.

Answer 1

1. The CST observed that the patient's blood placed in the test tube didn't form clot even after 7 minutes. She thinks the blood doesn't look right and this could be due to DIC (disseminated intravascular coagulopathy).

2. CST's response can be considered as the most appropriate one. She observed that the patient's blood placed in the test tube didn't form clot even after 7 minutes. She thinks the blood doesn't look right and this could be due to DIC (disseminated intravascular coagulopathy). She told the surgeon about her doubts regarding DIC and the surgeon alerts the OR team including the attending obstetrician and anesthesia care provider. The quick response of the OR team averted any serious complications although the patient became slightly hypotensive.