whitewriter | Scooter v car

A 30 something year old male with Hx 8-12 cans of beer daily (heavy alcohol use) leading to an admission for acute pancreatitis earlier in the year) - was hit by a car which ran him over --
THEN BACKED OVER HIM ---

an ambulance was called, he was intubated, and a needle thoracotomy performed on his upper left chest to decompress his L) lung - and he was whisked away to RPAH.

Now he sits in general ICU (non-covid) on a bunch of pain killers, not quite wardable due to the amount of pain meds he needs:
ketamine infusion, PCA oxycodone, dexmedetomidine (which we only run in ICU, and is also for behavioural management and a tiny bit of pain relief) - and after 1 day they added in some spinal blockers to try and help him through the L) broken ribs and R) broken collar bone.

Thinking back I wished I had looked at his x ray cause that may have been a sight to see.

GCS 15, now that he's in ICU.

We try to move him .. as few times as possible. He manages to wiggle his bottom in bed, and technically soon should be aided to get up and walk or at least pivot into a chair. He has 1 chest drain.

When I washed him, I gave him a 4ml ketamine bolus (at 0.2 mg/1ml thats... 0.8mg in one hit) IV and he got disorientated and had some sort of out of body experience (he turned to us and said "you moved me to anonther room!" and we said no... "this bed is so much farther forward then before" and it took a lot of convincing for him to accept that we hadn't gone anywhere except left and right in the bed, and then 2 cm up on the sheets... I hadn't moved the bed at all). I also ensured he had 20mg of valium 30 mins prior and got him to press that PCA so much he was almost asleep again, right before we started.

Then on the second night I helped another nurse - they'd dropped his ketamine rate down to 1.5ml/hr and she bolused 2ml on top and they added a regular valium 10mg TDS - honestly, I'd have given him a stat valium prior if he was mine -

He literally cried in front of us. Watching a grown man cry is not fun. Those spinal blocks seem only mildly effective.... at rest.

I wish the person who backed over him could come and help him have a wash, or at least see how horrible it is doing it.

His saving grace is that his pelvis and legs, head/neck and spine are ok. The car literally would have driven right over his nipples...

Covid restrictions must have eased enough for the neighbors to finish their massive renovations: there is extreme drilling next door. Yesterday, and today. Yesterday I was still on night shift and had a lot of trouble sleeping, even with the ear plugs (which were great at sound drowning but painful having them in. You can guess if I turned up to work after that horrid sleep... or not...