Hey guys, new to this site and first post. I am obviously posting in the wrong spot but for some reason it will not let me post on other threads/forums. Please place this in appropriate area. I am new ICU nursing 1 3/4 yrs. and hopefully sending apps in this fall. I love this site and find it refreshing to have so many well exp. CRNAs willing to enlighten me on this topic (and all other topics), it my be simple but bear with me
anywho....
Background: I work in 24 bed MICU/SICU level 1 trauma center.
59 y/o pt. ant wall MI, unknown downtime, lifeflight to us
Used artic sun (protective hypothermia), started CVVHD p 3 days as he was apparently going into mulitsystem organ failure.
What appeared to me as ARDS was progressing fast. AC 15 100FiO2, peep 10. Gas looked something like 7.11/60/42/28. Its july so we have all new residents and they asked what I thought I should do? ME!? So i asked if they were thinking ards, they aggreed. I suggested uping his rate and increasing PEEP to 15-20. They concurred. Meanwhile pt. on levo 30 mcgs. After about 10 min. his resp status improved, but after about 15 min. his pressure was in the toilet. We ended up coding him at shift change, gave three amps of bicarb, levo wide open, fluids wide open. No epi or atropine needed. converted to ST with pulses
My questions is was he really this sick or did we just clamp down on his hemo dynamics because of the aggressive peep?

any info on this would be great
again, great site. LOVE YOU GUYS!:You_Rock_Emoticon:
Lance