4am:
Rounds 10 am
- Weight Down 30 gram
- D11-
- 1/2 Sodium Acistate
- TFG - 80
- Urin 3.3 6 Stools
- Cayhieror out
- MAPS - 42-60
- BP 62/40 (40)
- Amp 24
- Hz 7
- MAP 13
- FI02 - 32-54% currently 34%
- TCM - 37-59…currency 48
- Blood Gas: 3a: ph 3.7 po02 71. HemGlobin
- Histogram …..
- Medication
- Atavist - Given as needed
- Melenorme
- Dopamine turned off last night
- …etc
- Imagine Chest Exra - Desecrate in
- Has some Edema -> General swelling from liquids
- ??? stinum status:
- RFP: …Blood - Liver test. . .Renal Function Plan…Sodium, Potassium Chloride, CO2,
- GIR - Glocus Infusion Rate. . .(adult 4-6 amount of sugar it can handle) ??? in TPN. . increase of the dextrose. . .11.5%
- TPN - Went up in Protein stead (Amino Acid)
- Respiratory:
- X Ray - 8am tomorrow
- Pneumo Thorax has decreased in size.
- Pneumomediastinum still there but small
- Echo Cardiogram Today
- Bili in morning
- Nuero: MRI when stable … next week
- Endocrine..???
- ???Glucose is up…decrease hydrocortisone? Titrate down...
- RFP -> Tomorrow Morning
- Morphine: instead of manual additions of Morphine, simply increase dosage of morphine
6pm - Tyler
- Mean Down 11.5
- Delt P - 21
- 28-35% O2
- TCM: 47
- Melrinone is now off since 3pm
- Echo Came back and looks pretty good
- Maybe: Still has NO PDA (PPHN), but is still shunting
- LESS SHUNTING - improved from the previous echo
- Tonight - Monitor for PPHN -
- Next step - Pneuma might be drastically better tomorrow
- Night time: Not likely to make any changes, but will continue to drop FI02,
11:15 PM - Sarah
- Doing well
- He opened his eyes at about 9pm
- Sucking on his breathing tube and the nurses finger
- 9:30 pm breath a lot on his own, comfortable breaths
- 11:10 pm - Switch to a different ventilation: Draker - Conventional Ventilator
- More Gentle
- A step down from what he was on
- 30 Breath scheduled
- 15 of his own breaths a minute
- O2 -26%
- Morphine - still increased continuous drip
- But not as many PRN
- No X Ray Tonight
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