Tuesday, June 12, 2012

Adding value

PTR
Hello, what's happening?

Man with moustache
Hi, this woman is having plasmapheresis and she's reported some peri-oral tingling.  Her ionised calcium before we started was 1.3 so I started with the standard citrate flow, but since she's gotten these symptoms I've turned it down 40% because I'm worried that she might be getting a citrate induced hypocalcaemia.

PTR
Mmmmmmmm.
[to patient]
How are you feeling now?

Patient
A bit better I suppose.

PTR
[to man with moustache]
So what do you think?

Man with moustache
Well we're nearly finished and her symptoms have resolved somewhat.  I think we might as well continue on as we are.  She's due for another run tomorrow, so what I might do is leave a note for the home team asking them to give some calcium prior and start off the citrate at a lower flow rate as well.

PTR
Ok then, that sounds good.  Anything else I can help you with?

Man with moustache
No, that's all thanks.

PTR
It was nothing.
 

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