Browse categories and answer follow-up questions to refine your symptom profile.
Immediate stabilization
Resuscitation priorities
Airway compromise from decreased consciousness
If unable to protect airway, rapid sequence intubation
Breathing failure from aspiration or pulmonary edema
If hypoxemia, supplemental oxygen to target SpO2 92-96%
Circulatory instability
If hypotension, isotonic crystalloid 500-1000 mL IV bolus
Active bleeding
If life threatening hemorrhage, massive transfusion protocol consideration
Hyperviscosity recognition triggers
Time critical pattern recognition
Neurologic symptoms
Headache
Confusion
Somnolence
Seizure
Focal neurologic deficit
Visual symptoms
Blurred vision
Diplopia
Visual field loss
Mucosal bleeding
Epistaxis
Gingival bleeding
Easy bruising
Cardiopulmonary symptoms
Dyspnea
Chest discomfort
Heart failure signs
High risk contexts
Known Waldenström macroglobulinemia
Known multiple myeloma
Hyperleukocytosis with acute leukemia
Polycythemia with neurologic or visual symptoms
Monitoring and access
Early monitoring setup
Continuous cardiac monitoring
Dysrhythmia surveillance during electrolyte shifts
Frequent neurologic reassessment
Interval mental status trend
Two large bore IV access
Apheresis compatible access planning
If severe symptoms, arterial line consideration
Frequent blood sampling support
Immediate consultation and activation
Team activation
Hematology urgent consult
Symptomatic suspected paraprotein hyperviscosity
Apheresis service urgent consult
Neurologic symptoms plus suspected paraproteinemia
Visual symptoms plus suspected paraproteinemia
Mucosal bleeding plus suspected paraproteinemia
Oncology consult
Suspected plasma cell dyscrasia or lymphoplasmacytic lymphoma
If hyperleukocytosis, leukemia team consult
Cytoreduction pathway
Early pitfalls to avoid
High risk errors
Red cell transfusion before viscosity control
Potential viscosity increase and neurologic worsening
Diuretics without intravascular assessment
Potential hemoconcentration and viscosity increase
Rituximab initiation before plasmapheresis in Waldenström
IgM flare risk with symptom worsening
Delay in apheresis for classic triad presentation
Time dependent neurologic and visual injury risk
SymptomDx is an educational tool for medical professionals. It does not replace clinical judgment. Verify all clinical data and drug dosages with authoritative sources.