A Bloody Mess

I'll discuss Scott Anspaugh first. He's now had two different courses of chemotherapy for lymphoma. If the first doesn't work, it's unlikely that the second would do much better, and we see that it has recurred,this time in his bone marrow, inhibiting normal cell development. That means he isn't making enough red cells, white cells, and platelets. You can transfuse red cells and platelets, but can't transfuse white cells because those transfused white cells could attack his own cells. So he's dangerously low on infection fighting cells, and that's why isolation was needed. (He'd never stay in the ER for this, but they've taken lots of liberties with actual protocol over the years, haven't they?) You could've argued for bone marrow transplant earlier, too. What happens leading up to the bone marrow is, after a match is found, he'll get very large doses of chemotherapy and radiation (larger than he's gotten before), to try and kill as many cancer cells imaginable. These doses will probably kill all his bone marrow stem cell (these are the cells that eventually grow and divide into the blood cells). Then the bone marrow from the donor is removed. The donor will be the one who has all the pain--think of dozens of needles going into the bone to harvest marrow. Then that marrow is prepared and then infused into an IV. After a week or two, hopefully it will take in the bone marrow of the recipient and start to divide and form blood cells. during this time he'll be in isolation and require transfusion and antibiotic to get him through this time.

Hyperemesis Gravidarum is a condition of extreme vomiting during pregnancy to the point that she becomes dehydrated and can have electrolyte abnormalities because of the vomiting. Treatment is with fluid and electrolyte replacement, and anti-nausea drugs if she'll accept them. Each medication is rated on potential to harm the fetus. A pregnancy class A medication means that there have been actual studies on pregnant women that prove that the drug is safe. (These will probably never be done in the future because of liability concerns.) Class B means that the drug has been shown safe in pregnant animal studies, but there are no human studies. Class C means that the med has shown some harm in animal studies, but you have to make a judgment on whether to give it. Class D means that the drug may be harmful in human studies, but there may overriding concerns to the safety of the mother and it can be used in these cases. (The most common is in an epileptic-a seizure could kill the fetus and harm the mother, so you continue anti-seizure meds even though they may be rated Class D.) Class X means that there should be no reason you ever give this drug--the most famous is thalidomide, the anxiety drug that caused the kids in Europe to be malformed.

The old Chinese man was having pericardial tamponade from the gunshot wound. The sac around the heart was filling up with blood and impairing its ability to pump blood normally. Treatment is with draining it as quickly as possible with a needle into the pericardial sac.

I'm not familiar with Hemo-A, the blood replacement, but I assume it is a source of fluid replacement that also may have some ability to carry oxygen to cells, and thus is like blood.