What a DAY!

Today I helped care for a traumatic brain injury patient, which was a definite first for me! She was sixteen years old and had flipped her car while skipping school see to her forbidden boyfriend.

I think, in my naiivity, I didn’t realize just how sick she was until another nurse came by and shook her head, looked at the ICP, and stated, “You guys have been fighting one heck of a war with this one”

I was absolutely engrossed in the dips, waves, dives, swoops, climbs, peaks and creeps of her ICP, CPP, MAP, and brain tissue oxygenation. All day it was: Mannitol, propofol, ativan, Hypertonic saline, levophed, open the EVD, close the EVD, and on and on.

We weren’t titrating medications, we were titrating hope.

Speaking of EVDs, I actually had the opportunity to see the neurosurgeon drill a hole in her head and guide the EVD into a ventricle. Oddly, the insertion actually seemed a lot less complicated than setting up the lines for the transducer and monitor!

And she was the first person I ever “bagged.” I was standing there as we prepared her for a head CT. “here” said the respiratory therapist. “Bag her for me while I figure out the oxygen tank.” And so I discovered what it feels like to literally keep someone alive just by squeezing a bag.

As I left the unit she was being whisked to the OR to have a bone flap removed. The EVD just wasn’t relieving the pressure.

She will either die soon or have a VERY long recovery. I thing the former is more likely.

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