Carl Ramjohn, age 73, was admitted to Carolinas Continue CARE Hospital at University from Atrium–Main. His primary diagnosis was acute respiratory failure secondary to a motor vehicle accident. He had a past medical history of hypertension.

Situation:
Prior to coming to our LTACH, he was independent, working and in his work truck when an accident occurred. Several months prior, he had presented to the trauma service at Atrium–Main after a MVC. He suffered multiple injuries including bilateral rib fractures, left pneumothorax, bilateral pulmonary contusions, right hip dislocation, pubic rami fracture, hepatic lacerations resulting in exploratory laparotomy requiring washout and closure.

He had multiple other complications during his hospital stay prior to coming to our LTACH. He arrived for vent weaning and chest tube management. Prior to hospitalization, he resided at home with his spouse in Kannapolis, N.C., was functionally independent, and employed. The goal was for him to be able to return home.

Solution:
While at our facility, his treatment plan included physical, occupational and speech therapy, dietary care, and his multidisciplinary care team included a wound care nurse practitioner, physician, and pulmonology.

Results:
During his 100-day at our LTACH, Mr. Ramjohn eventually weaned from the ventilator, was able to be decannulated and did not require oxygen upon discharge. He passed a swallow evaluation and tolerated a dysphagia diet with nectar thick liquids. Because of his extended hospital stay with multiple complications and comorbid conditions, he was significantly deconditioned.

He slowly progressed with physical, occupational and speech therapy. He was able to self propel in the wheel chair and take some steps with a rolling walker. He was evaluated and accepted into the acute rehab program at Atrium Northeast. Daily family visits and family support were significant to his recovery. He completed rehab recovery and was able to discharged home with his spouse and home health care.