Blood work showed this, but what does it mean?!
Question: Blood work showed this, but what does it mean?
He then falls asleep after a couple licks from a popsycle in my arms, so I take him to put him in bed, change his shirt, check his temperature, which is still 101, and give him a dose of tylenol. I turn my back to get something to wipe off what tylenol he spit out and all of a sudden, everything that he had eaten, I need not go into details, use your imagination, came back up in projectile style vomiting. There are three more episodes of vomiting, with the last one ending in dry heaves. We take him back to the ER where they do a CBC. His temperature goes back up to 102, and every time he goes off to sleep, he wakes up gagging and heaving again. So we have to hold him upright just so he can sleep. The CBC comes back and they told us that his white count was WAAAY down. What kind of infection is this? And what does it mean if his white count is really, really, really low? Is that dangerous?
Oh yeah, his pulse ox was also lower than normal, too. They want it to stay in the upper 90s, and it was in the lower 80s. Could these two things go hand in hand given the symptoms?
Thanks for any answers.
Answers:
Sounds like he has sepsis, the main focus of which is the pharyngitis. Pharyngitis produces excessive amounts of phlegm in the top part of the throat, which is probably what's making him vomit.
The low white cell count indicates that the infection is viral rather than bacterial. He has a high fever which will cause dehydration. This decreases the fluid volume in the body, causing low blood pressure, so the heart has to work harder to pump blood around, hence it compensates by increasing heart rate. Toxins in the blood cause the pulse oxymetry (level of oxygen in the blood) to decrease. Again, the body compensates, it incrseases the respiratory rate in order to get more oxygen and "breathe off" the toxins.
Giving him regular Tylenol is a good thing to keep the temperature down (providing he can keep it down). Otherwise, keep him well hydrated with cold water and use cold compresses to keep the fever down. If he can't keep that down, then he really should be in hospital having intravenous (through the vein) fluids to keep him hydrated.
Mild sepsis can be treated at home with oral antibiotics. However, it can quickly become much worse so you need to keep a close eye on him. Keep monitoring his temperature and keep an eye on his urine output, if his urine output decreses, it means the infection is getting worse and you should take him back to ED.
Moderate sepsis is a serious infection, it can worsen extremely quickly and it's potentially life threatening. Treatment requires hospital admission and is usually with intravenous (IV) antibiotics.
Severe sepsis is extremely dangerous and generally requires at least High Dependency Unit (HDU) and often Intensive Care Unit (ICU) admission and multiple strong intravenous antibiotics.
Whether the sepsis is mild, moderate or severe is determined by the vital signs (blood pressure/heart rate/pulse oxymetry/temperature/respiratory rate).
Hope this helps.
Emergency Department RN