FAUCI DIARY ARCHIVE — Thursday, March 19, 2015
https://faucisdiary.com/diary/2015-03-19

Text below is verbatim from the released PDFs, with the original line breaks.
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DIARY ENTRY — Thursday, March 19, 2015
Source: Diary Prequel, p. 434 of 2026.07.27_Diary-Prequel-.pdf
Words: 402
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All non-renal numbers going in the right direction. Still in acute
renal failure; however, the rise in creatinine is perhaps a bit less “steep” – creatinine 5.9
and BUN 111. We may well have to start dialysis today. Decision to be made mid-day
today. His cycle (CT) is now up to 31.5 and so his immune system is certainly clearing
the virus. Persistent fever prompting broad antibiotic coverage. Had a scary episode last
night. As we were tapering him off heavy sedation it appeared that he was calm and
doing well with the taper. However with two nurses in the room and the rest of us
(physicians, nurses, WatSans, et al) taking evening report, he abruptly woke up in a
delirium flailing his arms and legs despite soft restraints (he is 6’2” and very strong). He
pulled out his PIC line and pulled out the tubing to his endotracheal tube. It was a
nightmare for the 2 nurses in the room who had to simultaneously press down with a
towel on the bleeding PIC line site, bag him through the endotracheal tube, hold him
down and try to get Versed into him. We all got up and scrambled to Don but this took
(even going at light speed) about 5 minutes leaving the 2 nurses in the room with 5
minutes of terror. Dan Chertow, Rick Davey and Tara Palmore went in and Bob Danner
and I manned the nurses station and read the monitor to the people in the room. We
decided that it would ne dangerous and non-productive to have everyone in the
room. Real scare came when Neil (head nurse on that shift), who was one of the 2
nurses with Kim, doffed, he noticed when he took off his inner glove that his hand was
bleeding. As you can imagine, the trauma of the prior 5 minutes and now a bloody hand
brought us all, particularly Neil, over the top. Luckily, the blood was his (injured his
hand against bed rail when holding down patient) and his gloves were intact. Tara
Palmore checked his gloves by filling them with water and there were no leaks. We
soon got everything under control and he is now the same as pre-event, only now under
heavy sedation, which we would have had to do anyway if we ultimately decide to
dialyze him. PIC line was replaced by VAT (Vascular access Team).