S – Severe Critically Ill patient with multiple drips, CRRT, and declining health.

B – This patient was a post-open abdomen patient requiring ventilation and sedation, multiple vasopressors, and CRRT. The Patient’s health continued to decline regardless of the care provided. The patient’s BP and Heart Rate were unstable throughout the night.

A – Capt Tschirhart and Capt Miessner worked very hard to maintain the life of this patient during the night. Throughout the night the patient changed sedation medications, was maxed out on 4 vasopressors, had multiple medications administered and drip rates changed in addition to 3 code blues. Tschirhart and Miessner started CRRT, however, the patient decompensated, and an emergent rinse back was conducted. Shortly after CRRT the first Code Blue was called. From this point on and throughout the night the patient’s HR and BP remained very unstable. Tschirhart and Meissner worked with Dr. Wagner and his team to continue to change/give medication and add additional drips to maintain HR and BP. Dr. Wagner was in the ICU most of the night, the longest I have ever seen a doctor during night shift. Pharmacist Kevin made and delivered more drips during that shift for a single patient than I have ever seen, possibly 20 bags or more, and was very responsive to all requests. Chapel Mount was called in and spent around 2 hours with the wife and son to help comfort them. SSgt Rodriguez and SrA Wolz were also valuable members of the team, running for supplies and gtts, recording, and providing high-quality CPR during codes. Capt Tschirhart spend the majority of the night at the patient’s bedside hanging and adjusting medications while Capt Miessner helped with charting and additional direct care.

R –Members of this outstanding team should be recognized for their dedication to the patient and family. They had to work together as a team and coordinate well with multiple medical teams to maintain the life of their patient and support his family during this critical time.