Question

While awaiting transportation to a facility with a CT scan, which of the following labs should be ordered for a patient with suspected subdural hematoma?

a) Alcohol level

b) Basic metabolic profile

c) INR, PT, aPTT, and platelet count

d) Vitamin K level

Answer 1

While awaiting transport for a CT scan for a suspected subdural hematoma, a Vitamin K level is not commonly prioritized; instead, tests related to coagulation status and blood loss potential are typically ordered.

Step-by-step explanation:

In the context of a patient with a suspected subdural hematoma, ordering a Vitamin K level lab test may not be directly useful. Such a scenario demands more urgent testing focused on assessing the patient's coagulation status and determining blood loss or ongoing bleeding risks. Typically, initial tests would likely include a complete blood count (CBC), coagulation profile (prothrombin time [PT], activated partial thromboplastin time [aPTT]), and a type and cross-match in case blood transfusion is required.

The assessment of cerebrospinal fluid (CSF) is relevant in cases where there might be suspicion of an underlying infection, the presence of abnormal immunoglobulins as seen in multiple sclerosis or to ascertain the presence of CSF leakage. However, for acute trauma leading to suspected subdural hemorrhage, the priority rests on imaging modalities like CT scans and acute management based on clinical presentation.