Test Your Knowledge

What is the appropriate patient status?

78-year-old female with a past medical history significant for chronic kidney disease, hypertension and diabetes returned to the ED with rectal bleeding that had worsened since her visit the day prior. Initial Hgb 10.9

Day of presentation:

0845: Observation order placed

0942: Inpatient order placed

1012: H&P assessment: lower GI bleed – internal hemorrhoid vs diverticulosis vs AVM. Plan for GI consult, serial H&H, clear liquid diet

1215: GI consult – bowel prep and colonoscopy tomorrow

2125: repeat Hgb 8.1

2312: transfuse 2 units of packed red blood cells

Day 1:

0457: Hgb 10.1

0738: Colonoscopy: internal hemorrhoids, no active bleeding. Can d/c if stable

0946: IM note: no obvious bleed on colonoscopy Plan to advance diet, monitor H&H with am labs

Day 2:

0458: Hgb 9.9

0855: Discharge to home

Would you Status:

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