You are caring for a Motor Vehicle accident patient who has…
You are caring for a Motor Vehicle accident patient who has sustained rib fractures on the right (8) and left (2). It is his 2nd day in the ICU, his input is 9500 and output is 2500 ml. The patient is intubated and the ventilator settings are PRVC mode, rate of 12/min, VT 500ml, fi020.50, PEEP 5 cmH20. The patient weighs 104 kg and is 6 feet tall. Patient is being infused with a neuromuscular blockage agent (norcuron). Abg’s on these settings: sp02 93%; pH 7.20, paC02 68 torr, pa02 56 torr, HC03 20 meq/L, Base Deficit -7. What is your recommendation? I. Recommend a diuretic II. Increase the tidal volume to 700 ml III. Increase the PEEP to 8 cmH20 IV. Keep the set rate at 12/min V. Increase the rate to 20/min