Transfer from M/S floor to our ICU today- emergent transfer. They gave report at the bedside. Septic, I'm sure. He was circling the drain when he came in and proceeded to go downhill. Constant seizing? (He was twitching/spastic). Hx of seizures but Tegretol levels WNL and was on Keppra IV. Has a hx of mental retardation so a baseline mental status is hard to judge. Difficult time getting pulse ox and BP to read because of movement. Finally got a BP reading in the 70s then it tanked to 50s, HR 140s, RR in 40s, put in a rectal probe and his temp read 107.4. Put cooling blanket on, gave Tylenol supp and applied Bipap. Fast forward a bit: Recheck ABGs showed pH of 6.8, too tired to remember CO2 but it wasn't pretty. Intubated, put in central line, and art line, gave Valium IV, started levo, propofol, numerous NS boluses. Had to stay until 9pm to catch up on all my paperwork. Had another patient that virtually got ignored as I couldn't leave the bedside of my other guy. When I did, I was running to get supplies, or talking to the docs. Thankfully my fellow nurses stepped up and were at the bedside to help me and also check on my other pt. I love my coworkers and charge nurse!
Fastforward: BP came up to 90s, temp was down to 100.4 R when I left. I'm tired and need to go to sleep but my brain won't shut off. I have never seen a temp that high, have you?
Transfer from M/S floor to our ICU today- emergent transfer. They gave report at the bedside. Septic, I'm sure. He was circling the drain when he came in and proceeded to go downhill. Constant seizing? (He was twitching/spastic). Hx of seizures but Tegretol levels WNL and was on Keppra IV. Has a hx of mental retardation so a baseline mental status is hard to judge. Difficult time getting pulse ox and BP to read because of movement. Finally got a BP reading in the 70s then it tanked to 50s, HR 140s, RR in 40s, put in a rectal probe and his temp read 107.4.
Put cooling blanket on, gave Tylenol supp and applied Bipap. Fast forward a bit: Recheck ABGs showed pH of 6.8, too tired to remember CO2 but it wasn't pretty. Intubated, put in central line, and art line, gave Valium IV, started levo, propofol, numerous NS boluses. Had to stay until 9pm to catch up on all my paperwork. Had another patient that virtually got ignored as I couldn't leave the bedside of my other guy. When I did, I was running to get supplies, or talking to the docs. Thankfully my fellow nurses stepped up and were at the bedside to help me and also check on my other pt. I love my coworkers and charge nurse!
Fastforward: BP came up to 90s, temp was down to 100.4 R when I left. I'm tired and need to go to sleep but my brain won't shut off. I have never seen a temp that high, have you?