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[Music] hi John holy Karen hi how is your chef pretty good actually busy okay yeah okay excellent so are you taking I am yeah you think of me report nice so you probably dont know this gentleman because he just came in last night hes a 28 year old male he had a came in with a diagnosis of septic shock right had a six day history of malaise chills fever and came into the emerge and at that point was fairly decompensated at that point so we the they did full cultures and what he was started on picked as broad-spectrum antibiotic and were just awaiting those cultures so he can narrow that focus a bit he does have family here theyve been in to see him earlier today and and theyve theyre out right now theres gonna get some dinner so Ill be back probably a little later and I did mention that you were coming so so lets get started so basically CNS wise hes a GCS of ten with hes got an 82 out of 15 its rest hes been both minus one to plus one with his goal or a subzero his icds C i
