Palmo Anest

Life after spine injury

I had a patient, 50 yr old gentleman. MVA few months ago, cervicle spine fracture at C5 & C6 level. Plating done but still quadriplegia (paralysis of both arms and both legs) and dependent on ventilator (breathing support by a mechine) and minimal inotrope to maintain his BP. He is conscious and alert.

A month after his injury. The other hospital which he initially admitted to (in another state) has sort of forced him to ask for transfer to us as we r his hometown hospital. We accepted him to our ICU on humanitarian ground, we don't have a HDU setting at that time. The fact that his wife is a staff nurse helps too.

He was in sepsis at the time of transportation. On arrival to our ICU, his BP crashed. His gasses exchange very poor. Needed high PEEP and 100% Oxygen, high inotrope support. On top of that he still went into bradycardia and BP unrecordable for a few times.

We resuscitated him.

The wife being a medical personnel knows very well what she is facing. But the other family members (siblings of the patient) are still in deniel and think she didn't do enough for him. Instead of settling in a public hospital, they wants her to put him in a private hospital to get 'better treatment'.

They went to ask from private four times, each time, the private hospital called us up, ask the patients condition, we told them, they politely refused to take over the patient.

A month after the admission, patient still with us, he came out of sepsis but still ventilator dependent. Ventilating with minimal SIMV settings, minimal inotrope. Alert and conscious but quadriplegia. A long bettle ahead.

We all know that eventually we have to transfer him out of the ICU with a ventilator at the general ward. With the ERV we had, it's more like a terminator then a ventilator...

God bless his soul and give strength to his family.

posted by LT @ 11:22 PM