Update Monday Nov 10 1pm
Friday : 11.07.08
Aaron was the best I’ve seen him thus far. He could remember names and context. Plus he was able to retain information from previous days. I even noticed his personality coming through. We were able to hold very short conversations (via the alphabet board). I explained the crash a bit more to him and he was visibly upset. His right arm and right leg took the brunt of the impact, with the iliac bone shattering. The iliac bone is the upper and largest part of the bony pelvic girdle. He also broke his right collarbone. Aaron is experiencing numbness and heaviness in his right leg and arm. He uses his left arm to lift the right into position and rarely moves his left leg.
Saturday : 11.08.08
Aaron’s mental status had diminished from Friday. He was rather agitated and confused and spouted disconnected comments. He was less able to concentrate and converse. I also noticed the staff put his mitts back on – leading me to believe he was trying to pull out tubes again. The agitated and confused stage, Rancho Level 4, varies with each patient. The treatment guidelines for this stage are basically just low stimulation to best manage and limit agitation until the patient progresses to the next level on the Rancho Scale. Thus no TV, no radio, dimming of the lights, and family visits are limited to 10-15 minutes each.
Sunday : 11.09.08
Again, Aaron’s mental status was diminished. He wasn’t remembering or retaining much. I also noticed he was quite angry. Aaron had the gastric stomach tube insertion procedure around noon and was very upset about it. I realized he didn’t remember that we had discussed it an hour prior, plus the night before. He spent the remainder of the day in a bit of pain. The nurse has to wean him off of the Fentanyl, because he was in a bit of respiratory distress and they needed him to cough on his own – but was unable to due to the sedation. Quite a few hours later, they were able to administer another dose of Fentanyl and he was off to sleep. Fentanyl is one of the most powerful opioid analgesics with a potency approximately 81 times that of morphine.
- Tedi
