# Of plasma donation and emergency room visits **URL:** \ **Category:** Miscellaneous and Personal Stuff I Must Share\ **Created:** [February 26, 2018, 12:38am UTC](https://boards.straightdope.com/t/of-plasma-donation-and-emergency-room-visits/809581 "2018-02-26T00:38:36Z")\ **Posts on this page:** 8\ **Page:** 2
**Author:** ![Ambivalid](https://avatars.discourse-cdn.com/v4/letter/a/a5b964/32.png) [@Ambivalid](https://boards.straightdope.com/u/Ambivalid)\ **Post date:** [February 27, 2018, 2:39am UTC](https://boards.straightdope.com/t/of-plasma-donation-and-emergency-room-visits/809581/21 "2018-02-27T02:39:36Z")
For nearly the past year, I have been plagued with a mystery illness that, among other symptoms, has lowered blood platelet count. Part of the process of trying to figure out what was wrong with me was undergoing a liver biopsy. Before the biopsy, I talked to the doctor about my bleeding concern due to the lowered platelet count. He immediately dismissed my concern, saying I was nowhere near low enough to be a serious problem. So I underwent the liver biopsy, and guess what happened? Internal bleeding that formed a hematoma over my liver and required me to stay overnight in the hospital for what should have be just a few hours of my time. So basically I’m saying I don’t automatically feel assured by what a doctor says. Especially when the concern that the expert so condescendingly dismisses _is exactly what ends up happening_. It’s definitely not the first time I’ve felt not listened to by a doctor. ---
**Author:** ![DSeid](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/dseid/32/20194_2.png) [@DSeid](https://boards.straightdope.com/u/DSeid)\ **Post date:** [February 27, 2018, 4:25am UTC](https://boards.straightdope.com/t/of-plasma-donation-and-emergency-room-visits/809581/22 "2018-02-27T04:25:19Z")
Plasmapheresis is not without any risk. The standard informed consent includes a warning that things like tingling and cramping, or allergic reactions, _or fainting or seizures_, and more, _may_ occur, even though the procedure usually occurs uneventfully. Did you \*not \*read and sign an informed consent that listed those things? And if your blood pressure was seriously low as a result of low blood volume when the EMT got there there would had been no hemming about the IV. The fact that the EMT did not place one and that the ED did not place one right away is easily explained by her exam and blood pressure not being consistent with being low on blood volume. Btw, sudden onset of dizziness, turning blue, and passing out while laying down would also not be a typical presentation of being down a liter of blood gradually removed over at least an hour. That might cause gradual symptoms or symptoms upon rising. It is OTOH very consistent with vasovagal syncope. Lastly, be somewhat cautious about what you claim was the cause to your insurance company. It might bite you. I can easily imagine a circumstance in which the insurance company won’t pay as they say, based on what you have told them, it is the plasmapheresis center’s responsibility and, of course the center refuses to pay as well as they see themselves as having done nothing wrong. Guess who the hospital comes after _then_? Give you a hint: it’s a couple that has large debt already. ---
**Author:** ![Helena330](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/helena330/32/531_2.png) [@Helena330](https://boards.straightdope.com/u/Helena330)\ **Post date:** [February 27, 2018, 6:55pm UTC](https://boards.straightdope.com/t/of-plasma-donation-and-emergency-room-visits/809581/23 "2018-02-27T18:55:35Z")
> [@Bob\_Blaylock](#): > > It seemed clear that the reason that we waited so long was simply a matter of the hospital not having the staff and resources to process all the waiting patients any faster than they were. We were there for a total of about eight or nine hours, during which time we received what couldn’t have been as much as an hour of actual work done on our behalf. She was on a gurney in a hallway for more than two hours before anyone was able to see her at all. At least another hour or two before she was moved into a room, and connected to a machine that monitored her vitals; and at least two or three hours after that before a doctor finally saw her. I consider this rather an annoyance that what attention was given to her was so slow and drawn out. With adequate staffing, everything that took place over that eight or nine hours would surely have taken place in less than two hours. > When the doctor finally did see her, he rather hastily diagnosed her as having vasovagal syncope, and began the process of discharging her. > > She had been laying down the entire time, and although she did not feel well, she was alert and conscious up to this point. As soon as she sat up (for the first time in several hours) she reported feeling dizzy. They moved her to a wheelchair, and began wheeling her toward the exit, and after perhaps a few dozen seconds, she was nearly unconscious. She was conscious and aware, but in a very mentally-confused state, and unable to respond coherently to questions. At that point, the doctor decided to put her back in the room, and give her the IV. > > The IV took, perhaps, about half an hour to three quarters of an hour to empty into her. It was probably at least half an hour or so past that point when we were able to get the doctor to come in and see her again. While we were waiting, she decided to cautiously sit up; and on doing so, experienced no symptoms. We did wait for the doctor to return, and for the IV to be removed, before she tried standing up and walking. No dizziness, no fainting, no other related symptoms. She remained conscious, alert, and up to her full mental function. > > So, for the several hours that she was in the ER (and probably from some time while she was in the ambulance on the way) she was able to remain conscious and alert, but very noticeably unwell, as long as she stayed laying down, suffered dizziness and near-fainting if she sat up. After she received the IV, she seemed to recover almost completely. > > I have to assume that if she had received the IV immediately on arrival at the ER, she would have recovered almost immediately. Whatever was wrong with her as of the time that she finally did receive the IV, it rather obviously was something for which the treatment needed to correct it was that IV. > > Now what else would that IV have corrected, other than her having insufficient blood volume? > > And how would her blood volume have been insufficient, if the plasma place had been replacing it in the manner that they were supposed to be doing? If she’d been dehydrated in the first place. As someone who’s visited emergency departments too many times, I just want to say that her stay in emergency isn’t atypical, hallway and all. Most likely she had bloodwork and a urinalysis right away. They don’t offer fluids immediately. I’ve had to wait five or six hours for them. I’d guess a nurse or PA came in and took her history and an account of what happened. They’re pretty knowledgeable and informed the doctor of her condition. If she’d been truly emergent the doctor would’ve seen her sooner. It sounds like they were observing her over time and waiting on test results. Pretty standard. **Seanette** , I hope you’re feeling much better. ---
**Author:** ![Doctor\_Jackson](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/doctor_jackson/32/32_2.png) [@Doctor\_Jackson](https://boards.straightdope.com/u/Doctor_Jackson)\ **Post date:** [February 27, 2018, 7:52pm UTC](https://boards.straightdope.com/t/of-plasma-donation-and-emergency-room-visits/809581/24 "2018-02-27T19:52:54Z")
> [@Bob\_Blaylock](#): > > At that point, the doctor decided to put her back in the room, and give her the IV… > > The IV took, perhaps, about half an hour to three quarters of an hour to empty into her. It was probably at least half an hour or so past that point when we were able to get the doctor to come in and see her again… > > After she received the IV, she seemed to recover almost completely. > > I have to assume that if she had received the IV immediately on arrival at the ER, she would have recovered almost immediately…? I am not a real doctor, but I do understand correlation and causation. What makes you so certain that the IV did anything to cause her to feel better that the additional time alone would not have done? What makes you so certain that the IV did not provide a placebo effect? You can’t be sure, and that is the point most people here are trying to make. The IV could have simply correlated with her feeling better or it could have caused her to feel better, but the former does not imply the latter. There are simply too many variables to draw an accurate conclusion. I am glad she’s feeling better, though, whatever the cause. ---
**Author:** ![Bob\_Blaylock](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/bob_blaylock/32/3235_2.png) [@Bob\_Blaylock](https://boards.straightdope.com/u/Bob_Blaylock)\ **Post date:** [February 28, 2018, 12:53pm UTC](https://boards.straightdope.com/t/of-plasma-donation-and-emergency-room-visits/809581/25 "2018-02-28T12:53:15Z")
> [@Doctor\_Jackson](#): > > I am not a real doctor, but I do understand correlation and causation. What makes you so certain that the IV did anything to cause her to feel better that the additional time alone would not have done? What makes you so certain that the IV did not provide a placebo effect? You can’t be sure, and that is the point most people here are trying to make. The IV could have simply correlated with her feeling better or it could have caused her to feel better, but the former does not imply the latter. There are simply too many variables to draw an accurate conclusion. > > I am glad she’s feeling better, though, whatever the cause. _“Some circumstantial evidence is very strong, as when you find a trout in the milk.”_—Henry David Thoreau She spent hours, lying on a gurney at the ER, neither getting worse nor getting better. After many hours, the doctor came in, made a hasty diagnosis, and tried to release her. On sitting up for the first time in those many hours, she nearly blacked out again. On finally receiving the IV, she almost immediately and fully recovered. Was it a placebo effect? Was it just a coincidence of timing that she received the IV at the time she was going to recover on her own without any treatment? Neither is impossible, but given the evidence, I have to say that both are extremely unlikely. You might almost as well argue that it was her imminent recovery that caused the IV to be administered, as deny that it was the IV that caused her recovery. ---
**Author:** ![Bob\_Blaylock](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/bob_blaylock/32/3235_2.png) [@Bob\_Blaylock](https://boards.straightdope.com/u/Bob_Blaylock)\ **Post date:** [February 28, 2018, 12:56pm UTC](https://boards.straightdope.com/t/of-plasma-donation-and-emergency-room-visits/809581/26 "2018-02-28T12:56:54Z")
> [@Helena330](#): > > If she’d been dehydrated in the first place. > > As someone who’s visited emergency departments too many times, I just want to say that her stay in emergency isn’t atypical, hallway and all. Most likely she had bloodwork and a urinalysis right away. They don’t offer fluids immediately. I’ve had to wait five or six hours for them. I’d guess a nurse or PA came in and took her history and an account of what happened. They’re pretty knowledgeable and informed the doctor of her condition. If she’d been truly emergent the doctor would’ve seen her sooner. It sounds like they were observing her over time and waiting on test results. Pretty standard. > > **Seanette** , I hope you’re feeling much better. According to Seanette, the EMTs in the ambulance considered administering an IV, but they arrived at the hospital before reaching the point of making that decision. I have very little doubt that if the IV had been given at that point, she would have been fine by the time it was finished, and wouldn’t have needed to spend the next several hours being mostly ignored and neglected at the hospital. ---
**Author:** ![Joey\_P](https://avatars.discourse-cdn.com/v4/letter/j/919ad9/32.png) [@Joey\_P](https://boards.straightdope.com/u/Joey_P)\ **Post date:** [February 28, 2018, 1:09pm UTC](https://boards.straightdope.com/t/of-plasma-donation-and-emergency-room-visits/809581/27 "2018-02-28T13:09:10Z")
> [@Bob\_Blaylock](#): > > According to Seanette, the EMTs in the ambulance considered administering an IV, but they arrived at the hospital before reaching the point of making that decision. I have very little doubt that if the IV had been given at that point, she would have been fine by the time it was finished, and wouldn’t have needed to spend the next several hours being mostly ignored and neglected at the hospital. You have very little doubt about anything you’v made your mind up about. You still don’t seem to get that she came into the ER not bleeding, broken or dying, so she doesn’t get to skip to the front of the line. You even mentioned that other people had been waiting there as well. Shouldn’t they get to go first? What are you actually angry about? If she had passed out during the donation, but came to and was fine, would you be mad? If the EMTs started an IV and she was fine when she got there and the two of you just up and walked out, would you be mad? If she was admitted to the ER, got an IV it fixed her and you were out the door in a half hour, would you be mad? Honestly, every time I read this, I think you’re just angry that you spent 8 or 9 hours in a hospital. Either that or you don’t trust medical personnel. Let me ask you this. How would you feel if she got an IV as soon as she got to the ER, it made her feel better and she left. Then, 6 hours later, she got up to do something and passed out? Would you be mad that they discharged her when she [as decided by you] clearly wasn’t ready? ---
**Author:** ![Helena330](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/helena330/32/531_2.png) [@Helena330](https://boards.straightdope.com/u/Helena330)\ **Post date:** [February 28, 2018, 7:38pm UTC](https://boards.straightdope.com/t/of-plasma-donation-and-emergency-room-visits/809581/28 "2018-02-28T19:38:14Z")
> [@Bob\_Blaylock](#): > > According to Seanette, the EMTs in the ambulance considered administering an IV, but they arrived at the hospital before reaching the point of making that decision. I have very little doubt that if the IV had been given at that point, she would have been fine by the time it was finished, and wouldn’t have needed to spend the next several hours being mostly ignored and neglected at the hospital. You still don’t know whether she’d have gotten them, regardless. I’m not minimizing what either one of you went through and I’m glad it sounds like **Seanette** is ok, but I just don’t see anything wrong here. Yes, it sucks that you had to sit around and I’m certainly sympathetic but welcome to health care in America. I’ve waited for six hours in the emergency waiting room with excruciating abdominal pain and I’ve sat in the examination rooms or a hallway with the same so I completely get it, but that’s how it is. She’s ok and you have information about her health you didn’t before that can guide future decisions. If there’s anything or anyone to blame, it sounds like your area is in desperate need of another hospital like mine is. [Previous page](https://boards.straightdope.com/t/of-plasma-donation-and-emergency-room-visits/809581.md?page=1)