TICU Patient Clinical Progress Report (July 28-30)

The patient remains in the TICU on a ventilator (PSIMV, 35% FiO2) with an EVD in situ and stable ICP (11-16). Sedation includes Dormicum, Morphine, and Nitrocine. Nutritional changes were made by stopping TPN and increasing Peptamen Intense to 40ml/h. Vitals showed significant hypertension (192/109) and tachycardia (124), along with oxygen desaturation episodes.

Ventilator settings were adjusted (PEEP increased to 10). Clinical focus shifted to EVD management as it ceased draining; an urgent CT scan was ordered. Blood results showed anemia (Hb 8.5) and elevated CRP (13). Sedation weaning began, and nutritional support was transitioned to a trial of alternating Peptamen Intense with Novasource GI Forte at 50ml/h.

The patient underwent a left frontal burr hole for a new EVD placement in theatre and returned to TICU. Post-operative vitals improved (BP 155/90, P 64). Current management includes ongoing neuro observations, nutritional support with additional constipation management (Movicol, Hyfiber), and a comprehensive medication regimen including antibiotics, analgesia, and neuro-supportive drugs.