Mr. Bobby L. Hudson JR., PA, BSPAS

When a patient has sufficient blood volume and lacks one or more components, a complete blood count (CBC) test can help determine if a patient requires a transfusion by measuring four blood components: red blood cells, white blood cells, platelets, and hemoglobin. If any of the patient's component counts is significantly below a standard range, the patient will likely need a blood transfusion. The complete blood count test uses a needle to extract a small amount of blood for testing.

Blood transfusion recipients should be tested for their blood type, which is one of four different types: type A, B, AB, or O. Patients with A, B, and O blood can only receive a blood donation matching their blood type or of O blood, which is known as the universal donor. Those with AB blood are considered "universal recipients"; they may receive A, B, AB, or O blood. Further complicating blood types is the presence or absence of the RhD antigen, adding a positive or negative modifier that should also be considered. Incompatible blood donations may cause transfusion sickness, such as a hemolytic reaction, where the body fights the donated red blood cells.

In certain emergency or trauma situations, medical teams often do not perform a complete blood count (CBC) test or blood type test. In those cases, patients are often given O negative blood, which is universally accepted. Some patients have their blood type on a medical card or bracelet, allowing emergency medical teams to issue compatible blood without testing.

Transfusions are performed by inserting a needle attached to an intravenous line (IV) into a vein in the body. This IV line is attached to a bag of blood that steadily dispenses blood into the patient's bloodstream. The type, volume, and components of donated blood depend on the patient's condition and needs. After the transfusion is complete, patients are generally permitted to resume normal activity, unless prohibited by a condition or injury. Some patients may experience bruising or soreness around the area that the needle was inserted.

At times, a second complete blood count test is performed to determine if the transfusion has brought patients' component counts to normal levels. Some patients may require multiple blood transfusions to reach a healthy blood volume and blood component count.

Once patients' blood volumes and components reach sufficient levels, they will generally begin to feel better. Patients of all ages, from newborn infants to elderly adults, can receive a blood transfusion.

• Migraines: one of the most prevalent types of headache, migraines typically last from two hours to three days, causing a throbbing pain on one side of the head. Nausea, sensitivity to bright lights, fatigue, and blurred vision all may accompany migraines. While migraines have no known cure, medications and lifestyle modifications may ease symptoms. Avoiding behaviors that may trigger migraines such as lack of sleep or loud, repetitive noises can improve headaches.
• Tension headaches: also known as stress headaches, these headaches are characterized by pain in the upper top part of the head and behind the eyes. Tension headaches are common and have no exact cause; however, certain practices may increase the likelihood of developing them. For example, wearing one's hair up in a tight hairstyle or wearing a restrictive hat can put pressure on the scalp, leading to a tension headache. Other causes of tension headaches may include alcohol or nicotine use, caffeine, teeth grinding, stress, overexertion, and eye strain. Some people find posture improvement, alternating sleeping positions, and neck exercise can alleviate tension headaches. Over-the-counter pain relievers such as ibuprofen (Advil, Motren) and naproxen sodium (Aleve) may also reduce tension-headache pain.
• Sinus headaches: this type of headache causes pain in the sinuses, but may progress to pain and pressure in the eyes, forehead, and cheeks. These headaches are often accompanied by nasal congestion, fatigue, and ache in the upper teeth and may or may not be caused by sinus infections or sinusitis (sinus inflammation). Some sinus headaches are allergic headaches, which arise from allergic triggers such as seasonal allergies (pollen allergies) or hay fever, causing sinus pressure and facial pain. Other symptoms of allergic headaches include nasal congestion, irritated or watery eyes, runny nose, and sneezing. Allergic headaches may be treated with antihistamine medications such as cetirizine (Zyrtec). Allergic headaches are common during pollen season, which is usually around springtime.
• Cluster headaches: these headaches occur suddenly and cause stabbing, sharp pain from one eye down to the one side of the neck. They are often referred to as the most aggravating and painful type of headaches. Other symptoms of cluster headaches include nasal congestion, droopy eyelid, and enlarged pupil on one side of the face. In the past, it was widely believed that cluster headaches were caused by a bevy or "cluster" of multiple types of headaches, such as a combination of an allergic headache and a tension headache. Medical experts now recognize that cluster headaches are a separate and unique form of headache. Cluster headaches last for around twenty minutes to two hours. They may recur throughout the period of a day or several weeks, but usually dissipate within a month. Treatment for cluster headaches includes over-the-counter pain medications such as ibuprofen (Advil, Motren) and naproxen sodium (Aleve). Prescription Prednisone can help with swelling and Verapamil may reduce pain by relaxing the blood vessels.

Living with headaches is challenging; headaches can prevent people from fully enjoying life. Medical treatment and care in avoiding certain triggers can help those with headaches begin to feel normal once again.

Tracheostomy is performed for a variety of reasons when a bypass to the normal airway is needed. A patient may have an object lodged in their throat or have an injury that damaged their windpipe. They may have cancer or a swelling in their throat that stops air from moving freely. Sometimes tracheostomy is performed to make breathing easier when patients are paralyzed or have trouble coming off a ventilator.

A tracheostomy can be temporary or permanent. A temporary tracheostomy tends to heal over easily when the tube is removed, leaving a small scar. A permanent tracheostomy can make speech difficult at first. It takes time to learn how to use the throat and air in a new way.

Tracheostomy is a fairly simple procedure, but it can make all the difference in a life or death situation.