Can You Help me Turn

A lot of time in the ICU is spent turning patients.  Every two hours we turn our patients to prefect bed soars (pressure ulcers).  Right at shift change yesterday the oncomming nurse calls me into her room to help turn her patient.  I walk in there and say to her “hey are you aware of all this blood under his back” and “did you know that his central line is bleeding like crazy”.  This was her first time into the room and she had not seen either.  We gently turn the patient slightly and notice that his sheets under his back are saturated with blood. He had recently had spinal surgery and had two JP drains.  Both were full of blood, his back dressing was compltetly saturated. We lower his head to look at his back and he becomes extremely anxious, we check his sPO2 to find it in the 50%!!!  Quickly we slap on the non rebreather mask and the nasal cannula slowly his stats come up to the 90’s.

We look at his spinal dressing, its about 12 inches long and saturated.  WHile turning him we notice a foul smell.  Yep, he had soiled his bed at the same time.  So here we are with a patient bleeding from his fresh surgical site, saturated central line dressing, soiled, and desatting.  Both charge nurses run in.  We call the neuro surgeon.  He runs up we quickly drain the JPs and they refill.  The filling begins to slow.  We change the dressing, the site looks ok.  We get the patient clean.  He finally stablizes.

 

The joys of ICU nursing.