Simple and effective treatment.

On my last week on my cardio placement I went down to ICU to treat a pt. He was 78 yo who was admitted with a AAA which was surgically treated. His past medical history was that of Bronchiectasis,IHD,RA and occular melanoma. He had had a NSTEMI a few days previously in ICU. Objective Ax determined.Spo2 levels-86% on 12L NRBM,RR 20,BP was 126/60 and pulse was 98. He stated that he was normally productive but was especially productive at the moment and was bringing up alot of thick tenacious sputum M2P3. Cxr- revealed bibasal lower lobe atelectasis with a query of (L) ll pneumonia. He was afebrile at the time but was finding it hard to breathe and stated that he badly needed to get some phlegm up.ABG's revealed reduced O2 levels with slight increase in Pco2 levels.

For my treatment I administered a neb to reduce the viscosity of the secretions and assist further treatment. I then repositioned the pt as he was slumped in bed. I educated the pt on ACBT and put the pt in (R) sly and added percs and vibes during TEE's. I made sure that the pt was comfortable the whole time as he was after abdo Sx few days previously. He was very productive on this side. Obs were monitored throughout and at the end of the treatment the pt 's stas were 92% he was breathing at a steady rate and was more comfortable. He commented on how he "really needed that". So just goes to show, simple treatments can have a massive influence on the pt and the condition...