My shift last night felt a lot like when I first got here. There was a lot of action going on throughout the unit all night. I was assigned the 20 year old again and another 45 YOF. She was relatively stable for the unit. She was not intubated or sedated, but she was still in respiratory failure. She was on the proning scheduling and it was doing great things for her. Every time should would get up to eat or go the bathroom her o2 sats would drop in the 70's, but the second we would lay her prone they would jump right back up to the high 90's. She was an easy patient to have so I was able to spend most of the night with the 20 year old. He remained very critical. His vent setting were all maxed out along with his sedation. He was lying prone and his o2 sats were 88% all night. There is nothing else really to do at this point but wait and hope his lungs start to recover.
On the floor we had a patient go in to AFIB with a rate of 170-190 so we cardioverted. Which was nice for me to help out on because that's one of the main things we do on a daily basis in the cath lab. None of the residents had any clue on how to use the defibrillator so I was able to teach them a few things. (I doubt they would admit it) I have really been amazed at the autonomy of the residents. I think some of it is because the staffing was so short they were needed to take a bigger role, but a lot of them aren't/weren't ready for the training wheels to come off.
We had two other patients pass on last night. We also had to emergency intubate two other patients. On a positive note, we had a lady get extubated (remove tube and off vent) on the floor with plans to downgrade her to another floor. I mentioned in one of my first posts that every time someone gets extubated because they are improving, the hospital makes an overhead announcement and everyone cheers. I have only heard this a total of three times. But I have heard it twice in the last two shifts. Also most people get extubated during the day and I work nights, so that doesn't mean people are not improving.
I will more than likely get my 20 YO again tonight, so I will continue to update the blog with his status.
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