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Anna Garcia's Death
Transcript of Anna Garcia's Death
She had low hemotocrit levels at 25% when her normal levels should be 36-46%. She also had low hemoglobin levels at <8 g/dl, when her levels should be 12-16 g/dl. These complications mean that she is severally anemic. This was caused by the fact that her Splenic artery was occluded making it so that once blood entered the spleen it could not leave. Then, because her spleen then ruptured she lost 500 ml of blood. Anna's abdominal cavity was obviously hard and distended. Upon further inspection, it was revealed that this was caused because she had lost 500 ml of blood into her abdominal cavity. This internal bleeding is cause by the rupture and hemorrhaging of the spleen. Her left kidney also was pale and showed the beginning signs of necrosis, which was caused by her anemia. Because Anna was anemic, her liver did not get enough oxygen or nutrients, which would have caused her Kidney cells to become pale and eventually die. Also, her blue/gray nails show signs of oxygen deprivation. This showed signs of anemia which could be caused by internal bleeding There are many steps that could have been taken to prevent this tragic death. In the short term, Anna should have recognized an enlarged spleen was causing and gone immediately to a doctor. A doctor would have recognized signs of splenic sequestration and give Anna an immediate red blood cell transfusion. When Anna was young and was showing signs of splenic sequestration, a doctor could have preformed a Splenectomy A splenectomy is the surgical removal of the spleen. When the spleen is removed it eliminates the possibility of splenic sequestration but raises the chance of infection severely. Most sickle cell patients have this procedure done at a young age. The fact that she was anemic could have caused damage to all of her cells. Her nervous system could have been damaged by the lack of nutrients to the brain and spine, so cells die. Her respiratory system could be damaged by both the damage caused by lack of oxygen and nutrients damaging her lungs. Her lungs may become overworked because the body will begin to use feedback loops to increase breathing to increase oxygen levels. Anna would have been much more vulnerable to disease because her immune cells could not reach their target cells. The blood filtering system would also be damaged because of the pooling inside of the spleen. This would cause a major drop in hemoglobin levels which would cause there to be an oxygen deficiency because oxygen is the thing that carries oxygen. Her urinary system will be affected because the body will try to get rid of the excess waste not being filtered by the spleen. The kidneys may become overworked as well as the bladder. Also, because the spleen is not functioning properly, it can cause infection to other parts of the body, which would damage multiple systems. When the spleen enlarges, it could push upon the stomach and cause anorexia. Anorexia can cause malnourishment and dehydration, which when paired with anemia can be extremely dangerous because your cells will die from malnourishment. This can also cause the muscles of your heart to die, which will cause blood to not be able to get to your cells as easily, and for the heart to be overworked. Also, the spleen could push against the diaphragm. This could cause severe breathing problems that would cause less oxygen intake and a larger strain on the lungs. Because of the already low hemoglobin levels and the fact that sickled red blood cells, and anemia, there will be a severe lack of oxygen. This will also lead to the destruction of organs and systems. Blood clots are always a serious issue. Blood clots are when the blood trying to reach cells is blocked, causing blood flow to be be restricted. In Anna, her Splenic Valve was clogged with sickle cells because sickle cells are very sticky. This caused her blood to enter her spleen, but not leave, which lead to its enlargement. Blood clots can destroy any cell becase when blood clots form they cut off blood supply to cells. When a blood vessel becomes to full, it can burst. A blood clot in other parts of the body can cause serious issues such as strokes. Anemia can have a severe affect on the body. Firstly, because of the lack of oxygen reaching cells, cells will die. This can damage all of the body's systems. With a hemotocrit level as low as 25% paired with sickled blood cells, and low hemoglobin levels, her cells had extremely low oxygen. Anemia also affects the cardiovascular system because the heart wants to pump the blood faster so that cells can get enough oxygen, but because the anemia may be damaging the heart tissue, the heart is also being injured and overworked. Increased breathing may happen because the body will try to increase the intake of oxygen. When the kidneys begin to fail, a lot of complications can be set in. Firstly, the body cannot remove the toxins from the blood well, which can hurt cells of the body. The kidneys also regulate the amount of water in the body. When the kidneys are not regulating the water, the body will become dehydrated which can lead to malnourishment of cells. The kidneys also produce hormone called erythropoietin that stimulates the formation of red blood cells. When erythropoietin is not present, the bodies anemia would worsen. Seeing that she was already dangerously anemic, this low level would undoubtedly damage the body. Also, when the body is low on glucose, the body goes to the kidneys to release glucose. When the kidneys can't do this, the body will remain at a low glucose level and then cells will not have enough energy to function. Seeing that Anna already has type 1 diabetes, her glucose already had trouble entering cells. With not enough glucose that isnt even entering cells, Anna's cells would have become very weak and died Also, stents could have been placed in her splenic artery when it was shown that the possibility of occluding with sickle cells was eviden when she was young. In the short term, Anna could have taken plarvix. Plarvix is a prescription medication that ois taken once a day to thin blood throughout the day. When symptoms of splenic requisition were first showing she could have taken Advil which is a quick acting blood thinner.