KMCH hospital in Coimbatore

Pediatric Intensive Care Unit Treatment Summary

Patimt Name: Sriram P Age: 14 years

Date of admission in PICU: 27.10.2022

ID: 1853044/G70849 Treating team: Dr A Ganesan (Gen Surgeon), PICU Team (Dr Mullai Baalaaji, Dr Kavitha Joseph, Dr. Sangeetha), Dr ShanthaKumar (Pulmonologist), Dr Kandasamy (Nephrologist), Dr Rohit (Neurosurgeon), Dr Sudhakar (Pediatric Neurologist)

Master Sriram, 14 year old boy sustained abdominal injury following road traffic accident near kallakurichi on 8.10.2022 at 11 AM,admitted at salem medical college on 9.10.2022 for abdominal pain, CT abdomen showed duodenal perforation, emergency laparotomy with peritoneal lavage done with jejunostomy tube placement, Right and Left ICDT inserted for B/L pleural effusion, tracheostomy done on POD-9 in view of prolonged ventilation, was on antibiotics and vasoactives for septic shock and child was brought to KMCH in view of clinical deterioration.

On arrival at EMR, he was in cardiac arrest and was revived after 5 cycles of CPR. He was in hypotensive shock and noticed to have bleeding from surgical site. He was resuscitated with crystalloids and escalated vasoactive support. Hemoglobin was low and was given PRBC transfusion. He continued to remain comatose, hence initiated on neuroprotective measures. CT abdomen showed mild hemoperitoneum and pneumoperitoneum and diffuse mesentric thickening. CT chest showed bilateral consolidation due to aspiration and mild pleural effusion. CT brain showed no trauma related neuroparenchymal injury. He also has Acute kidney injury and Liver dysfunction. Pan cultures sent and antibiotics initiated. Currently he is on mechanical ventilation, has 3T/15 GCS with no motor response, hemodynamically stable on vasoactive drugs, with no active bleeding. He needs re-exploration surgery and neuro evaluation. This interim summary is given at the request of family.