10.12.21 ICU 19

Aimee has a broken leg!! On top of everything else going on in her body. 2 weeks ago she had a shower at home with no noted events, but ever since that time she has been really sensitive about her leg being moved and holds it in a different position. I brought it up to her nurses here many times to ask that they be careful moving it. I thought that she probably pulled a muscle or that her hip was hurting, but yesterday I noticed the knee was more swollen and somewhat warm. They did an x-ray this morning and sure enough it is broken above the knee joint. 😩 Orthopedics will be putting a knee brace on to immobilize it. I am hopeful that she will feel a lot more secure and less stressed with turns. She is known to be at a higher risk for fractures, but this is our first experience with normal cares causing one. 

This morning general surgery came to repack her open abdominal wound. It looks clean and healthy after yesterday’s procedure. They will be leaving it open  and repacking it twice a day as it hopefully heals back up.  

Also, she had a tough night with several extra boluses of dilaudid on top of her drip. She is easily startled and begins panicking with movement. It seems like she thinks she is choking. There is a difficult play right now between keeping her sedated and keeping her lungs in the best shape. The team keeps vacillating between using things like cough assist to keep her lungs open or not using it to avoid trauma to her fresh trach. The two sides of the argument finally came to an agreement this afternoon. We will only use cough assist if we absolutely have to and can’t clear her lungs. Otherwise we will do chest PT with the vibes every 6 hours to keep her lungs as open as possible. Hoping that this will be enough as she has had multiple events of thick secretions causing desats this morning.