night 4, yet another peaceful one...

aneurysm lady went for her planned pack removal and formal closure during the day, made it back from theatre amazingly a second time, not that acidotic either! even more amazingly, i managed to get her off dopexamine a few hours ago, cuz her indices were getting a bit too good (cardiac index over 4 with resistance around 600)! if she maintains this kinda progress, should be able to get her off her noradrenaline too later today and head towards extubation...

got another rsi* under my belt tonight... an elderly dude producing copious amounts of pleural and peritoneal effusions over the last few months, cause for which still unknown, possible neoplastic, tb or some other shit, the only positive finding so far being benign mesothelial cells in his ascites. underwent elective unilateral pleurodesis on this admission, but then went into ventilatory failure afterwards requiring intubation, extubated onto bipap*, held at this level for several days on the unit, but suddenly and unexpectedly deteriorated during the day, with him tiring and his carbon dioxide reaching 11 soon after i came on shift tonight. nice grade 1 tube. carbon dioxide came back down to around 8, oxygenation never a problem.

no news of note for yet another night. the world is so boring this week.

food of the night:

shepherds pie, deli crumbed ham, muller fruit corner strawberry, crisps x2 again, tea

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* rsi = rapid sequence induction, bipap = biphasic positive airways pressure

posted by Chas at 07:57
go ahead, roll the donut!