An 80 year old women with severe anaemia secondary to GI bleed

Severe anaemia requiring urgent blood transfusion, correction of coagulopathy, referral to gastroenterology.

Mixed chronic respiratory acidosis and acute (NAGMA)metabolic acidosis.

Severe hyperkalaemia

acute on chronic renal failure

Normal lactate/ glucose

Issues:

limits of care – how far do you go?

advanced health directives

Blood replacement

Invasive monitoring

Referral to appropriate service for intervention