Case Study 2

A 62-year-old male was admitted to a Level I Trauma Center reporting fevers for three days. On initial assessment he was noted to have tachypnea and tachycardia, as well as the following co-morbidities:

• Sepsis

• Hypertension

• Type II Diabetes Mellitus

 

He was admitted to the ICU due to Myastenia Gravis and high risk for decompensating. He was treated with antibiotics and IVIg, and intubated and placed on ACVC ventilation. After three weeks he failed extubation due to hypoxia accompanied by atrial fibrillation with RVR. A trach and PEG was placed and our team was consulted.

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Special Care Unit

Upon admission, his ventilator setting:

• Mode:  ACPC

• Ventilator Rate:  16

• FiO2:  50%

• PEEP:  5

• PIP:  23

 

In addition to his Nursing care, the patient received comprehensive treatment from Respiratory Therapy, Physical Therapy, Occupational Therapy, Speech and Language Pathology.

 

He was successfully weaned from ventilator in ten days, and de-cannulated at the same time. The patient made exceptional functional gains and was able to discharge home two days later, ambulating 200 ft with moderate independence. 

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