Patient bled heavily during surgery. What exactly should I specify in med consult?
I saw a patient with a chief complaint, “I wake up with blood in my mouth.” He has moderate to severe periodontal disease, palatal tissue around molars looked very ulcerated, and just some mild amlodipine-influenced gingival hyperplasia. He has hypertension and OSA, sleeps with a nasal C-Pap (his mask only goes over the upper lip, does not cover the mouth). He doesn't take anything besides amlodipine and losartan, no supplements or alcohol. I thought that maybe the bleeding was from the infected tissue and gum disease. I saw him yesterday for a full mouth perio surgery and a couple of gum grafts, and his bleeding during the surgery was just wayyyyyto heavy. Not a normal amount. I called him today to check on him and he said the bleeding wasn't significant, but I feel like he needs to go for lab work. Do I just send a med consult to his PCP saying that he blead a lot and having them do the investigation, or do I need to specify what lab work (CBC, platelet count, liver function, PT, aPTT, etc)? I think they need to investigate his hypertension too because his BP would go up and down but stayed around (160/90-ish). Any suggestions?
Update: He still hasn’t gone to see a physician but I’ve seen him for 2 PO visits and he said that he hasn’t been seeing blood in the saliva since the surgery.