Ok

You are requested by the surgeon to do anesthesia for a proctocolectomy and ileostomy on a 75+ y/o patient.

Hx:

Severe Ulcerative Colitis
Thrombocytopenia
s/p CVA with residual weakness
HTN
COPD
Previous MI 10 yrs ago with CABG

NKDA

Comes from home with severe ulcerative colitis resulting in severe GI bleed. Decision is made by surgery to have this intervention.

Currently in hospital getting cryo with H&H 9/28, plt 40K. Comes down to pre op area with cryo running. Surgeon tells you the case may have ~200-400 blood loss max but will take ~4 hours.

What do you want to do what questions do you have?

What will be your management?

What do you need before going to the OR?