ICU Sepsis – CVVHD

Case Description

Nick O. Kidman, a 54-year-old male patient admitted from ED for COPD exacerbation and uncontrolled DM Type 2; was transferred to ICU from the medical floor unit ED 2 days ago for PNA, ARF/AKI, and Sepsis. Patient has AKI with hyperkalemic fluid-overload, requiring dialysis. He also has sever hypotension, requiring multiple pressors which necessitates CRRT on CVVHD mode (versus hemodialysis). CVVHD mode was initiated in the morning before the start of the scenario. The patient is on day two of mechanical ventilation. Just prior to handoff, the patient’s BP dropped, Propofol was turned off, and Norepinephrine was titrated up to 30 mcg/min. The learner starts the case with SBAR hand-off report at 8:30am and manages care of this complex ICU patient.

Learning Objectives

– Demonstrate knowledge, skills and attitude in the care of patient diagnosed with Sepsis and Pneumonia

– Demonstrate knowledge, skills and attitude in managing patient on Continuous Veno-veno Hemodialysis

– Demonstrate knowledge, skills and attitude with intravenous drips for management of severe hypotension in accordance to the MEDVAMC Guidelines: Standard Intravenous drips for ICUs and ED

– Demonstrate knowledge, skills and attitude with intravenous drips for management of agitation R/T mechanical ventilation in accordance to the MEDVAMC Guidelines: Standard Intravenous drips for ICUs and ED

– Demonstrate knowledge, skills and attitude in managing patients on Insulin drip utilizing the MEDVAMC Hyperglycemia Protocol

– Demonstrate knowledge, skills and attitude in providing judicious; timely and safe environment for patient care