Laying Hands on the Patient Who Is Unstable: Bedside Diagnosis in Medical Emergencies

Travis Connor, a 32-year-old male, was receiving a blood transfusion for an upper gastrointestinal bleed while awaiting an endoscopy. However, he quickly developed diffuse abdominal pain and hypotension. A rapid response was activated, and house staff responded to his bedside. Attributing the hypotension to hemorrhagic shock, residents ordered a massive transfusion protocol and gave further blood products. But volume resuscitation had little effect on his hypotension, and his blood pressure continued to fall.

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