A 62-year-old male was admitted to Level I Trauma Center on November 25, 2016, reporting fevers for 3 days. On initial assessment he was noted to have tachypnea and tachycardia, as well as the following co-morbidities:
- Type II Diabetes Mellitus
He was admitted to MICU due to h/o Myastenia Gravis and high risk for decompensating. Exam on November 26th was consistent with Myestenia exacerbation. He was treated with antibiotics and IVIg. He was intubated and placed on ACVC ventilation. He failed extubation on December 4th due to hypoxia accompanied by atrial fibrillation with RVR. A trach and PEG was placed on December 9th. Patient was deemed difficult to vent wean, and the Special Care Unit was consulted.
Special Care Unit
Clinical information was reviewed by the Special Care Unit Team and the patient was accepted on December 16, 2016. He was on the following ventilator setting:
- Mode: ACPC
- Ventilator Rate: 16
- FiO2: 50%
- PEEP: 5
- PIP: 23
In addition to his Nursing care, the patient received comprehensive treatment from Respiratory Therapy, Physical Therapy, Occupational Therapy, Speech and Language Pathology. He was successfully weaned from ventilator on December 26th. He was also de-cannulated on December 26th. Pt made exceptional functional gains and was able to discharge home on December 28th ambulating 200ft moderately independent. The SCU team maintained communication and the patient to ensure that he functioned well once home.