Sunday, October 15, 2006

Intensive Care Unit

Jim crashed yesterday. Blood pressure in the 65/40 range, temp of 94, shivering, shivering, stumbly, mildly incoherent. Called 911 and a paramedic unit and an ambulance showed up. 5 burly men and women. They took him to the Emergency Room at WIlmington Hospital (the one he was in before) and I followed in the car.

IV fluids, IV antibiotics, and 4 hours did nothing to raise his blood pressure. They put in a central IV line so they would have quick access for meds and blood if he started to crash further. They started him on meds to raise his pressure shortly after I left at 8pm. Jim and I agreed that I was serving no purpose there except comforting him and exhausting myself. They were waiting for an ICU bed to open up in an affiliate hospital, at which time they would transport him there by ambulance. By 1am, his systolic pressure was into the high 90s range.

The diagnosis when I left him last night was sepsis. The ER DR thinks it's likely an infection in his liver, but they were not able to get a sample of the accumulated fluid in his belly to culture. The hospital takes sepsis very seriously, and that and the central line, which is prone to infection, are the reasons for ICU. ICU has severely restricted visiting hours, even for spouses, so I won't be able to see Jim until 11am. In a way this is a blessing, so I don't wear myself out with more days of bedside vigil.

Radiation starts tomorrow, and I need to conserve strength.

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