So I was on back up call the other night....I just got into bed when my partner texts me....

Here's the exchange:

parterner, "would you put in an epidural for induction for PIH with plt of 62?"

me, "no"

partner, "what about a spinal for c-section?"

me, "maybe...depends on how she looks"

partner, "do you think I'm NUTS for thinking about putting in an epidural?"

I thought about saying "yes, and they are big nuts ", but I didn't want to insult my friend...instead in texted "I think this patient should be sectioned electively rather than waiting for things to potentially get worse"

1 minute later, by pager goes off, and the number is L&D.....CRAP, partner still busy in the OR....I had to go in for the C-section.

Previously healthy nurse midwife patient referred to the call OB with bp 160/110 and "very dark" urine.

No previous history of exposure to anesthesia.

Looks ok....plt 62...hct 33....cr 0.7

neck stiff

no platelets available in house....

any thoughts?