What is your initial approach to this patient?
A: The initial approach should include:
- Immediate catheterization to relieve urinary retention and monitor output
- Close monitoring of vital signs, including heart rate and blood pressure
- Assessment of blood loss and ongoing bleeding
- Laboratory tests including complete blood count, liver function tests, and coagulation profile
- Evaluation for potential causes of urinary retention, such as trauma or pre-eclampsia
In this case, a urinary catheter was inserted with minimal output noted. This finding, along with other clinical features, should prompt further investigation into potential underlying conditions affecting renal function and fluid balance. She goes onto receive 7.5 litres of fluid in next 24hours under the watch of Critical Care Outreach Team (CCOT).
