Intubation...

Worked in the unit the past couple of nights, and for the most part, everything was very quiet. However, Wednesday night, the er admitted a pt under 40 y/o to PCU who had sats in the 60s down in the er, but by the time they got to the floor, they were sat-ing in the 90s. Then for some reason the sats dropped down to the 50s, even into the 40s, and they became completely unresponsive. So off to the unit they went, at almost shift change even. In the er, they pulled off 3000 cc of fluid with lasix. Anyhow, as soon as they came into the unit, anesthesia was called in to intubate. [For some reason, I believe I heard the er doc state that the pt had tracheal deviation to the left, but I didn't see the xray reports this evening past to know what had happened.] They were given a Diprovan drip to keep them sedated so they wouldn't fight the tubing. The BNP was only 309, which is elevated and thus the diagnosis of CHF. But at such a young age? The nurses speculated that they must have had HTN for quite some time for the heart to go into failure, or something else must be going on. I don't know how long they will be on the vent, but I felt so sad for them. The PCO2 levels were 118 and PO2 was 39 at the time of intubation. No doubt they were in critical condition. It was an interesting experience nonetheless, even if it happened too close to shift change. Emergencies are never planned for sure. I know some complained about them staying down in the er for so long, but when they came in, the main complaint was that the eyes were burning and that the feet were swollen. Not exactly a rush with those complaints. I truly believe that if they knew just exactly how bad they were, they would have gotten them straight to the unit without having to go through all of the waiting. I wish it were easier to educate people on the signs and symptoms that are serious and need attn right away. Ah well, now I am rambling.... after a long night of fairly quiet patients, I am just ready to go on to sleep.