Sunday, September 19, 2010

Happy List From PICU

Here is the other old writing I found from day 2 or 3.

A medical student came into Angelee's pediatric ICU room and asked if there was anything she could do for us.  I told her that I needed to make a happy list.  She was confused until I explained that I needed to record all of the things that had gone right, to help me cope when things looked bleak.  She got Angelee's records and helped me compile these encouraging thoughts:

Things that have gone right, in no particular order

Anglee was extubated in only 24 hours.  She is breathing well on her own, quicker than they thought she would.  Her head drain was removed soon after surgery.  She is opening her (one unswollen) eye, and looking around.  She is tracking with her eyes.  She finally looked over to the right (she was first staring straight ahead, then only looking to the left).  She can hear voices.  She understands sounds and recognizes familiar voices.  She is moving all her limbs.  Her lungs sound wonderful and clear.  Her heartbeat is strong and regular.  She responds to touch and pain.  Her sodium levels are self-regulating.  She is able to take in calories and protein.  Her labs all look good.

She likes her blankie and wants it close, showing higher thinking.  She is not in lots if pain with minimal morphine.  She pulls her socks off.  She resists someone else moving her.  All her pulses are strong and even, showing no damage from the IV lines.  She has good urine output.  There are no signs of infection in her sutures.

Her L5 fractured vertebrae is just fine.  She had no other major complications.  She had no organ injuries, and no other broken bones.  Her skull broke into pieces, which allowed the brain to swell out instead of down into the brain stem.  Trent saw her go out the window, so she could get to the hospital within minutes.

The medical student paused here, and said that Angelee was responsive to stimuli and pain even at her arrival on the helicopter.  The hospital staff was happily surprised to see this, as it is unusual and they were expecting something worse.  Angelee has spontaneous movement, meaning she is doing things on purpose.  She is responding to more stimuli, becoming a bit more alert.  The medical student said Angelee was making wonderful progress, faster than they thought she would, and that she was one of the best neuro cases they have had.

A good, encouraging list to be sure.


  1. dear janette-i find myself needing to play glad game myself(from pollyanna). It truly takes some weight off of those shoulders!love-shannon

  2. I love this post. I'm going to borrow the idea in my clinical practice. I suspect you made a very big impression on a future doctor.