Tuesday 09/01/09
Thane, the night nurse, said he continued with the good work that Melanie has done on Mike's face. There was a lot of suctioning that happened and he is sill on 40% fiO2 for his pressure support and he seemed to do a lot of over-breathing last night. They tried to see if it was a response to pain but found that he continued over-breathing so they turned down the pressure a bit and that seemed to work. in other words, his breathing is getting stronger and he may not need the support of the ventilator much longer. The next step is to put a T piece on. That is a T shaped tube that is connected to the trach opening that blows by humidified oxygen so Mike can draw his own breath. Cool! Depending on how he does, he may only need ventilator support at night or if he gets tired. The humidified air will help to keep the lung secretions moist so they can suction and things don't get bogged down. After that, they will try to go down on the oxygen level until it is that of room air.... the next step is to put him on a nasal cannula and voila! no more trach! I may be jumping ahead but wanted you to know the upcoming steps to Michael's healing process.

The labs were done late due to suctioning but his blood gas is pretty stable. His blood sugars were 161, a little high, but that's to be expected with the high calorie nutrition formula needed for healing. The propofol is continuing to be weaned, along with the fentanyl. Oxycodone has been initiated as an oral pain medicine and it seems to keep him comfortable. (15 mg was the last dose) Mike is a lot more awake and can answer questions by nodding or shaking his head. He is mouthing words and the nurses are trying to figure out what he means so he can get his needs met.

There are three attending doctors that rotate through the burn trauma unit. Dr. Morris came onto the service as of yesterday.
That should bring you up to speed today.
More later,
and so we go
JaCee