Let It Bleed - All Things Blood

[Camazotz Automat]

Bloody Hell.

Blood banks. Religious sacrifice. Science. Occult. Your Lynard Skynard anniversary blood drive t-shirt. Sex. Vampires. Medicine. Phobias. Blood spatter analysis.

A thread about a common thread we all share: B L O O D

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[onan]

I loves me some blood. So much to learn from the red, gooey, sticky, salty, liquid tissue.

How it throbs in the arteries and the sensation can be so telling when feeling the pulse. Bounding, PVC's, tachy or bradicardic. Then the chemistries and counts... so much they tell.

[HorrorRetro]

I used to work as a dialysis technician.  I was covered in blood daily.  We had protective gear, but you can't get the smell off you until you come home and take a shower.  If anyone isn't familiar with dialysis, it's basically artificial filtering of the blood when one's kidneys fail. It also removes the fluid that your kidneys would if they functioned normally. 

There are several routes that can be used to remove the blood from the body.  There is a Hickman catheter, which is placed in the jugular vein. This gives us external access via the catheter port.  However, it's not a good permanent access due to clotting, infection, and low blood flow volume.

The other access points are generally on the forearm, but a small percentage of patients have access in their thighs. The most common access is the arteriovenous graft. This is where an artificial tube is grafted to both a vein and artery. This is what an AV graft looks like:  http://img.photobucket.com/albums/v186/ILoveKewpies/dia7_dial_graft.jpg This gives great blood volume.  However, it involves the use of 14- to 16-gauge needles.  This is how large a 15-gauge needle is: http://img.photobucket.com/albums/v186/ILoveKewpies/needle.jpg
You need two needles, one for receiving the blood and one for returning it after it's been run through the dialysis filter. 

Once the blood is pulled from the body, it's run through the dialysis filter and is returned filtered and containing certain balancing electrolytes, based on the patient's specific needs. When the procedure is complete, on average, 3 hours later, the needles are removed, pressure is held for about 10 minutes, sometimes longer, due to the high blood volume pressure at the access points.  If you don't hold pressure, your patient is going to bleed out.

Once the patient is gone, you break down their dialysis machine and take the filter into another area to be reprocessed.  It's hooked up to high pressure water hoses that force the blood and filtrates out of it.  One thing it does not remove and you must remove manually is the cholesterol.  The first time I did this, I almost puked.  You have to literally scrape the cholesterol off the end of the dialysis filter.  When this is complete, you hook the cleared out filter up to a reprocessing machine which sterilizes the filter and then fills it with formaldehyde.  The formaldehyde is obviously thoroughly rinsed out before it's attached back to the machine on the patient's next visit.

I had never experienced tunnel vision until I was trying to get a patient to stop bleeding one day.  He had really high pressures, so I knew he took extra long to stop bleeding.  I had held pressure for about 15 minutes or longer.  I carefully pulled back the gauze and it looked good.  I turned to get a bandage, and when I turned back, there was a geyser shooting a good 4 feet in the air!  My vision zoomed into his access point, and that's all I saw.  I quickly got it back under control.  But that was my first experience with tunnel vision.

Patients generally are required to receive dialysis 3 times a week for 3 hours at a time.  They must monitor every drop of liquid they ingest.  This means everything from water to pudding.  Since their kidneys don't work, this fluid builds up in their body.   They are weighed when they come in with their "wet" weight and weighed again after dialysis for their "dry" weight.  Depending on the patient, this can be as much as 10 pounds difference.

Everything you never wanted to know about dialysis in a nutshell.  I have no idea why I typed all that up.  But, seriously, dialysis is something you never want to go through.  So get your diabetes under control.  The majority of our patients were diabetics who had lost kidney function.

[McPhallus]

Wow.  And to think I faced that at one point.

[BobGrau]

Is there such a thing as 'low blood pressure'? I get dizzy spells from standing up too quickly at least 2-3 times a day, and usually more. Also, if I get a minor cut or scratch it seems to clot in about a minute. I've always called it 'lazy blood syndrome' and attribute it to massive amounts of cannabis resin in my bloodstream.

So, am I special? C'mon Doc(s), tell me I'm special.

[McPhallus]

There certainly is low blood pressure.  It makes you feel weak and lethargic.

[HorrorRetro]

Is there such a thing as 'low blood pressure'? I get dizzy spells from standing up too quickly at least 2-3 times a day, and usually more. Also, if I get a minor cut or scratch it seems to clot in about a minute. I've always called it 'lazy blood syndrome' and attribute it to massive amounts of cannabis resin in my bloodstream.

So, am I special? C'mon Doc(s), tell me I'm special.

Yes, there is low blood pressure.  That's called hypotension.  High blood pressure is hypertension.  If you experience low blood pressure on standing, that's called postural or orthostatic hypotension.

The clotting sounds normal, so no worries there.  If you continue to have orthostatic hypotension, you might want to check with your doctor.  You may just be dehydrated.

[Sardondi]

I used to work as a dialysis technician.  I was covered in blood daily.  We had protective gear, but you can't get the smell off you until you come home and take a shower.....

Uhghh. A tough job. Plus that copper taste/smell in the back of your throat/mouth all day would get very old.

[Eddie Coyle]

         When I worked at a hockey rink, a co-worker had a Zamboni blade essentially sever his thumb/hand. Fucking disgusting, it took 4 sets of towels and a 100 MPH ride in a co-workers car to an ER(about 10 minutes away) to keep him from going into shock and losing his hand. It was saved, but with severe nerve damage and a year of rehab.

        But guess who had to mind the fort while my boss and co-workers raced to the hospital? Yup, and I had to mop up the massive pool/trail of blood that he lost. After 3 swabs of the mop, I literally had a bucket of blood. It was ghastly...I remember getting paranoid about exposure to viri, I didn't know if this guy had a risky lifestyle of whatever. But just a horror show.

            **  We closed the rink to the public for an hour while I cleaned up, and co-worker who was unaware of what happened showed up. As she entered, I was going to kneel over the bucket(the blood was still intermingling with water) and make it look like I was puking the blood up, but for once in my life I acted professionally. I should have done the gag.

[Camazotz Automat]

         When I worked at a hockey rink ...

Eddie, thanks for bringing up the most common blood situation I somehow neglected to mention: Accidents - experienced or witnessed - and the aftermath/clean up (as well as gags/practical jokes related to blood.)

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[McPhallus]

Uhghh. A tough job. Plus that copper taste/smell in the back of your throat/mouth all day would get very old.

As bad as that is, it must be even worse for the person having it done.  I remember walking by a dialysis room at the renal section of a hospital many years ago.  They looked like shriveled-up husks.

[HorrorRetro]

As bad as that is, it must be even worse for the person having it done.  I remember walking by a dialysis room at the renal section of a hospital many years ago.  They looked like shriveled-up husks.

I actually liked the job.  You get to really know the patients and their families.  With prep, treatment, and removal/entrance site care, they are there about 12 hours a week.  It's rare to have that much contact with patients in any other healthcare setting.  The bad part is that many do die while in treatment.  Some people tolerate dialysis for over 20 years.  Others can only take if for a few years. 

During my training and afterward, I wondered if I could go through it as a patient.  I honestly don't know.  Your life literally revolves around dialysis.  I just don't know if I could handle it. 

[PB the Deplorable]

AC/DShe - If You Want Blood...

[Sardondi]

As bad as that is, it must be even worse for the person having it done.  I remember walking by a dialysis room at the renal section of a hospital many years ago.  They looked like shriveled-up husks.

Yeah, brutal on the body. You don't really have all that many 20-year anniversaries on dialysis.

[ziznak]

can some body go over blood types?  why the hell is some blood crimson and somewhat runny... like mine... and other blood somewhat darker and seemingly thicker?  I know that depending on diet and things that your blood can have different ingredients or chemical makeup but one thing I noticed growing up was a major difference between my blood and a few other friends that I knew and watched lose a few pints here and there.  I know my blood of course very well, it doesn't gross me out, and I think nothing of sucking on my own cuts... I'm less grossed out by loved one's bloods especially family members for some reason... I'm guessing subconsciously I know that my family members have somewhat the same blood that I do?? something?? anyways if anybody can shed light on some of my questions both scientific and psychological that'd be cool.

[HAL 9000]

Is there such a thing as 'low blood pressure'? I get dizzy spells from standing up too quickly at least 2-3 times a day, and usually more. Also, if I get a minor cut or scratch it seems to clot in about a minute. I've always called it 'lazy blood syndrome' and attribute it to massive amounts of cannabis resin in my bloodstream.

So, am I special? C'mon Doc(s), tell me I'm special.

OK, you're special.

But orthostatic hypotension is completely normal - and rarely pathogenic. More common as we age. Generally produced by pooling of blood by staying in a position for a period of time (laying or sitting typically), then suddenly standing. When gravity takes effect, less blood temporarily flows to your brain, until your sympathetic nervous system quickly kicks in constricting your blood vessels and/or increases your heart rate, thereby alleviating symptoms.

However, there are a few drugs which may contribute to orthostatic hypotension: typically beta-blockers (for blood pressure - they lower your heart rate) or erectile dysfunction meds (Viagra, Levitra, and Cialis), all of which dilate blood vessels.

So here (generally) is the cure:

patient: "Doctor, it hurts when I do this."
doctor: "Then don't do that."

If laying in bed (the most common position for these symptoms), get up slowly: sit on the edge of the bed for a minute while your blood pressure self-regulates, then continue your normal activities.

Then again, you could have a brain tumor.

Your clotting sounds normal, but if you're concerned, ask your doc to authorize you for a PT/PTT test. This will confirm if you're normal, and is easy and cheap. Vitamin K is very important in the clotting mechanism, and if you're deficient, could increase clotting times - which is why all newborn babies receive a phytonadione (Vitamin K) shot shortly after birth.

Of course, I'm assuming you're not on sodium warfarin (Coumadin) for atrial fibrillation, or other meds which purposefully decrease clotting mechanisms (and huge pet peeve of mine - THESE ARE NOT BLOOD THINNERS!). This phrase has worked its way into the vernacular, rather than the more appropriate term "anticoagulant." Anticoagulants DO NOT "thin" your blood - in fact nothing does except ingesting huge amounts of fluids or quick infusion of large amounts of IV fluids.

OK, that enough of tonight's episode of Dr. HAL.

   

[HAL 9000]

can some body go over blood types?  why the hell is some blood crimson and somewhat runny... like mine... and other blood somewhat darker and seemingly thicker?

The differences you noted have nothing to do with "blood types" per se (A - B - O etc.) But it is completely normal for there to be noticeable differences in blood appearances/consistency.

There are two common ways to express this "consistency" (thinner vs. thicker blood), but both are essentially measurements of the same thing, only described by using different measurement parameters.

The simplest method to understand is your hematocrit (Hct). This test is routine when you get a blood workup, and  is easy to understand this way:

A blood sample is taken, and put in a tube. This tube is placed in a centrifuge and spun very quickly (using hyperdimensional physics [joke]). All the red bloods cells (RBCs) get pushed to the bottom of the tube - the water, or plasma portion of the blood is what is left at the top of the tube. If the tube is half-filled with RBCs, then your hematocrit (Hct) is 50 (50%). If the RBCs only take up one-quarter of the tube, then your Hct is 25 (25%).

Normal values vary between institutions, but for healthy adults, it would be reasonable to say males' Hct are generally higher by a few points than females (accounting for menstruation)... but overall, "normal" would be ~40-55 (allowing for differences of opinion). So if your Hct is 25, I would recommend a transfusion. By the same token, there are risks to having too high a Hct - your blood is thicker (sludgy), so has a harder time moving though your body. This would be a bit unusual (too high Hct), but I have, in extreme cases, corrected this condition in babies by having an IV in the baby with a three-way stopcock - then withdrawing blood slowly, then replacing it with normal saline.

If you ask any med-tech or phlebotomist, they will instantly be able to tell you from experience, if your blood is "thick or thin." Of course, the amount of RBCs per unit volume will also affect the color - less RBCs the more reddish/pinkish... the greater amount of RBCs the darker/purplish it will be - meaning more sludgy, which actually has its own measurement related to gravity, known as the erythrocyte sedimentation rate (ESR). The ESR is not terribly useful in general, but can be be an indicator of an inflammatory response and a few diseases.

Most docs, when evaluating your "blood status" (for lack of a better term) will take into account your Hct and your hemoglobin (Hgb) which is the oxygen-carrying molecule in your RBCs. Both Hct and Hgb are routine tests almost always done with a standard blood workup - you should ALWAYS ask for a photocopy of your lab results from your doc (which damn-well better be free) so you'll have records of your own - you might notice trends over time others might not pick up on.

The other measurement is the mean corpuscular volume (MCV), which is measured in µm3. Look it up if you want - I'm a horrible typist, and have run out of energy...

[onan]

Is there such a thing as 'low blood pressure'? I get dizzy spells from standing up too quickly at least 2-3 times a day, and usually more. Also, if I get a minor cut or scratch it seems to clot in about a minute. I've always called it 'lazy blood syndrome' and attribute it to massive amounts of cannabis resin in my bloodstream.

So, am I special? C'mon Doc(s), tell me I'm special.

Such good responses. Normal clotting times kind of depend on the injury. A needle stick is different than a gun shot wound. Generally 5 to 8 minutes for the clotting process to do it's job. Take a daily dose of aspirin and it can be longer maybe 11 to 12 minutes.

In medicine we always talk about the "normal" condition. That is important to give us a benchmark. And without a benchmark lab values are worthless. That being said, the individual values of many components of one's blood can vary significantly. For instance hematocrit and hemoglobin levels can vary widely between individuals and other than the numbers being different there would be no discernible difference in the persons being tested.

When it comes to "thin" blood, Hal said it perfectly. There are situations where blood can become "thin" however. Picture a napkin and place a drop of water on it. Quickly the water has saturated an area of the napkin. Now same napkin and a drop of syrup. The Syrup will "stand" there for a moment or two before starting to soak into the fibers. Blood has many many components, one of then albumin. Albumin simply said makes the blood more viscous and less able to "leak" out of the blood vessels.

To your point of A,B,O... the types of blood. It all has to do with certain antibodies on red blood cells. There is A antigen and B antigen. Sometimes there is no antigen... Type O. These are genetically predisposed characteristics. You have what you have. since there are 2 genetic factors One can have type A which can be AA or AO, BB or BO, AB, or OO. Then you have the Rh factor which adds another variant. And it gets even more complicated than that. The last I read there are over 600 variations on typing blood.

[ziznak]

When I was about 12 I went to a school in downtown Philadelphia for middle school.  I grew up and still live in the Northeastern part of the city.  I've done the commute downtown a billion times in my life but it was during this stretch of schooling that I first started to make this daily pilgrimage.  Having had a very outdoorsy father I happen to be of the ilk that always has a knife somewhere on his person.  It's the best tool a person can have... especially if you bite your nails like I do.
  One day on our journey home I had decided that I was going to finish whittling a small stick I was working on.  At the time I was all about making little home-made stringed weapons so I was always making "arrows."  We were on the broad street line going a few blocks to 15th street where we would hop on a different subway line that took us out of center city where it went elevated into our neighborhood.  A sudden jerk of the train sent the "jiffy knife" I was using through the fattest most blood filled area in the tip of my left thumb.  The resulting cut was a GUSHER.  I remember after the initial cut just looking at the strange separation of flesh in my thumb and how quickly the blood had begun to flow.  I remember some black dude next to me kept asking me "why'd u do dat?" like I had done this on purpose. 
  Luckily we were regulars at a little snack stand at 15th st station (now forever closed) and the lady that ran it gave me a ton of tissues.  The thing was for the rest of our 45-60 minute commute and until I was home for well past 30 additional minutes this thing would not clot!!  I'm guessing it was the depth and quality of the cut.  The "jiffy knife" was more of a box cutter and less of a knife.  One of the blooodiest of my many wounds sustained this life... and a very memorable one. 

Later today I'll tell you guys how I sliced my stomach open on an I beam... stay tuned!!!

[HAL 9000]

The thing was for the rest of our 45-60 minute commute and until I was home for well past 30 additional minutes this thing would not clot!!  I'm guessing it was the depth and quality of the cut.  The "jiffy knife" was more of a box cutter and less of a knife.  One of the bloodiest of my many wounds sustained this life... and a very memorable one.

I don't want to be overly simplistic, but I think you nailed it regarding depth and object used to cut. Otherwise healthy people with "real" bleeding disorders tend to bruise easily and frequently; especially the elderly whose capillaries and skin are more fragile... so unless you think you bruise easily/frequently (which is just an injury to a vein or capillaries which leak blood into surrounding tissue layers, and are resorbed over time), or frequent nose/gum bleeds, I wouldn't worry. Besides, a lot of this stuff is normal as we age.

Then again, the next time you start bleeding, one of your clotting factors may go awry, and you might have a cascading event call DIC (disseminated intravascular coagulation), which unless treated emergently, you'll die.

If this should happen, can I have your computer and any other cool stuff? 

[MV/Liberace!]

Blood

[HAL 9000]

Blood

Funniest thing I've seen in a long time  I started LOL like the dad near the end.

[ziznak]

that vid is awesome.  somebody showed that to me a while ago.  I love the emphasis on the "D." 

and if you really want my stuff when I die Hal it's all yours... just try not to get lost in my "closet of misfit laptops.  Now with even more random PC boards!"

and here's a good one... sphenoid aneurysm... gack
don't click if you get grossed out easy
http://www.prochan.com/embed?f=41f_1348565550

[Mind Flayer Monk]

Eating/drinking blood from animals:

I have heard in conversation that metals are very rare in nature and animals such as killer whales, monkeys, and lions will often rip out and eat the liver of the prey first to get at the iron in the blood of the prey.

[BobGrau]

Eating/drinking blood from animals:

I have heard in conversation that metals are very rare in nature and animals such as killer whales, monkeys, and lions will often rip out and eat the liver of the prey first to get at the iron in the blood of the prey.

A guy I worked outdoors with was a magnet (hoho) for ticks, supposedly because he had an usually high amount of iron in his blood. Most of us would pick one up now and then, but he got them every day. Yuck. I fucking hate those things.

[Widget]

Not a very uplifting thread. But it's bad when it's your blood all over the place. It get messy, for darn sure. Yes, morphine can assist in keeping you from going into shock, but it has its concerns. It causes your heart to slow down, which can assist a medic in stemming blood loss even with a properly placed tourniquet, but it can also stop your heart completely when you're weakened from blood loss and if it's improperly administered.

[ziznak]

I'd like to be improperly administered morphine... can I drink it??  I've been that "tick magnet" in the past.  I cut through an area of high grass and bushes n stuff when I was late on my way to computer school.  I was still picking ticks off of my collar on the bus on the way home... Can't remember how many I found overall that night but I felt somewhat bad about leaving a few on the bus...Didn't want to make a scene so I just kinda brushed it off my shirt like it was nothing. 

Another time working a job in that same area I had a substantial stretch of non-sidewalked road to walk and the grass was high and it was tick time.  I spent half of that day at work tacking the lil fuckers to the wall in my tiny office...

[ChewMouse]

Not a very uplifting thread.

None of our threads are uplifting. It ruins the look of the quilt.

[The Alcoholic]