I've been interning in the ICU for less than a month and a double whammy like this is something I wasn't prepared for today. The first pt was a guy who got hit off his motorcycle by a speeding car. Unfortunately for him, he wasn't wearing any protective headgear and he landed head-first on a concrete pavement. Shame, shame. He was a pretty young fella, too. He was allready hangin by a thread when they sent him up from the OR, and he passed a few hours after he came to the unit.
The other case was an older adult who had been admitted many times before for FTT. This man lives with a wife who claims to "take very good care of him", but he was in extremely bad shape: very badly malnourished and dehydrated with severe electrolyte imblances. The man's thigh's were as thin as a wrist, and he had decubs developing in a lot of the bony prominences. Worst of all, he had a hx of cardiac problems and he also had a DNR so you can already see where this is going with the K+ imbalance. We were trying to bring him up a bit with IV fluids with Kcl, and the doc had to get pretty aggressive with the therapy but the pt just wasn't responding to it at all.
It was real drag doing post mortem care. One one hand we're trying to calm down hysterical family members who want to spend time with the body, and on the other hand the charge nurse is whispering to ask if could try to move things along because they need the beds for other patients. Our ICU was really hoppin' today. Almost half the pt's were sent down to tele to make room for new admits.
