So 4 days at Riverton hospital showed no improvement in her breathing AT ALL. In fact, she was getting worse and worse. She had a hacking cough and at random times she would grunt and flare her nostrils....she was whiny and lathargic and just plain miserable. She's older now, and she's really grabby, so she pulled her IV out. That was not fun. The nurse came in and told me that if she didn't eat and pee than they would have to come and poke her again to give her some fluids. I wasn't worried about that because she never lost her appetite throughout any of it. She was miserable, but she was still eating and peeing and pooping like she should be.
She slept a lot, like a lot a LOT! I think she was just too miserable to be awake so everytime she'd wake up, she'd drink a bottle and go right back to sleep. Her oxygen needs got so much worse and they turned her up quite a bit throughout the 4 days we were there. In the ER they turned her up to 2 liters....on the floor, they went to 3 liters, then 4 liters.....and she was still satting in the high 80's, low 90's. They were turning her up and up, loading her with steroids and giving her albuterol treatments often and she just wasn't improving. :'( I was so worried for her little lungs...and her little nose because she was requiring so much oxygen..... I just remember how in the NICU if they needed a higher amount of oxygen, like over 1 liter, that they move you to high flow so your nose doesn't get dried out. Can you imagine having 4 liters of oxygen blowing in your nose every minute? How miserable! They brought a little water thing and hooked it up to her oxygen which they told me would humidify the air so it doesn't dry her nose out. Poor baby.
I was super worried about her. When she was sleeping, she was still grunting and retracting really bad. I pretty much just held her for those 4 days...that's all I could do. Then on the night of our 4th night there....the pediatricians switched shifts and the new pediatrician on duty came in to check on her. I expressed my concerns with her, and she examined her. She did not like what she saw. She asked me how long she's been grunting like that....I told her since we got there, 4 days ago...but it seems to be getting worse and more often now. She asked me if she had been awake at all, responsive or playing....I told her nope, she's been sleeping a lot. She went and turned her oxygen up to 5 liters....no difference in her sats. She sat me down and explained that one of the main signs of distress in children is the grunting. The sound alone is bad, but when they are flaring their nostrils it's a major sign that they need more help than we were giving them. I immediatly cried thinking that the past 4 days my poor baby hasn't been getting enough support. I can't even imagine having that feeling of not being able to breathe....and to be a baby....and for days.....so sad. I wish I could breathe for her, or take her pain away. The pediatrician said that when she listened to her she was pretty sure the left side of her lungs had collapsed. She told me that they can't handle children/infants who require more than just the basic oxygen need, that they were going to have to life flight her to Primary's where they can give her the support that she needs. :'( :'( :'(
In preparation for the transport, they needed to put an IV in. Two different IV teams came in and tried. They would get the needle in the vein and then when they would go to flush it, the vein would blow and the saline would bubble up under her skin. She would scream out in pain. After about 6 tries, I lost it and told them to stop and give her a break for a minute. I know they didn't mean to, but she was in pain...she didn't feel good, she was screaming....and I was crying too. They had already tried 2 veins in each hand, 2 veins in her left food and 1 vein in her right foot and they all had been blown out with no successful IV. They decided to wait for the life flight team to come and see if they could get one in.
She slept a lot, like a lot a LOT! I think she was just too miserable to be awake so everytime she'd wake up, she'd drink a bottle and go right back to sleep. Her oxygen needs got so much worse and they turned her up quite a bit throughout the 4 days we were there. In the ER they turned her up to 2 liters....on the floor, they went to 3 liters, then 4 liters.....and she was still satting in the high 80's, low 90's. They were turning her up and up, loading her with steroids and giving her albuterol treatments often and she just wasn't improving. :'( I was so worried for her little lungs...and her little nose because she was requiring so much oxygen..... I just remember how in the NICU if they needed a higher amount of oxygen, like over 1 liter, that they move you to high flow so your nose doesn't get dried out. Can you imagine having 4 liters of oxygen blowing in your nose every minute? How miserable! They brought a little water thing and hooked it up to her oxygen which they told me would humidify the air so it doesn't dry her nose out. Poor baby.
I was super worried about her. When she was sleeping, she was still grunting and retracting really bad. I pretty much just held her for those 4 days...that's all I could do. Then on the night of our 4th night there....the pediatricians switched shifts and the new pediatrician on duty came in to check on her. I expressed my concerns with her, and she examined her. She did not like what she saw. She asked me how long she's been grunting like that....I told her since we got there, 4 days ago...but it seems to be getting worse and more often now. She asked me if she had been awake at all, responsive or playing....I told her nope, she's been sleeping a lot. She went and turned her oxygen up to 5 liters....no difference in her sats. She sat me down and explained that one of the main signs of distress in children is the grunting. The sound alone is bad, but when they are flaring their nostrils it's a major sign that they need more help than we were giving them. I immediatly cried thinking that the past 4 days my poor baby hasn't been getting enough support. I can't even imagine having that feeling of not being able to breathe....and to be a baby....and for days.....so sad. I wish I could breathe for her, or take her pain away. The pediatrician said that when she listened to her she was pretty sure the left side of her lungs had collapsed. She told me that they can't handle children/infants who require more than just the basic oxygen need, that they were going to have to life flight her to Primary's where they can give her the support that she needs. :'( :'( :'(
In preparation for the transport, they needed to put an IV in. Two different IV teams came in and tried. They would get the needle in the vein and then when they would go to flush it, the vein would blow and the saline would bubble up under her skin. She would scream out in pain. After about 6 tries, I lost it and told them to stop and give her a break for a minute. I know they didn't mean to, but she was in pain...she didn't feel good, she was screaming....and I was crying too. They had already tried 2 veins in each hand, 2 veins in her left food and 1 vein in her right foot and they all had been blown out with no successful IV. They decided to wait for the life flight team to come and see if they could get one in.
When life flight got there, they had a hard time as well. Preemies have strange veins and they're much harder than anyone else's veins because they have so much poking from IV's and blood transfusions and things when they're first born that the veins tend to branch out and instead of one strong good vein, they have lots of little ones that can't take the pressure...so they blow. The life flight finally got a good vein on their 4th try....so 10 tries total. My poor baby's hands and feet were black and blue bruised from all the blown out veins and she was knocked out....just pure exhausted.
In preparation to send her, they turned her oxygen as high as they could.....she was on 3 liters of oxygen through the nasal canula and then they had a bagged mask with 15 liters flowing. That's 18 liters. :'(
Because they finally got the IV in, and she was calm and stable. They decided she didn't need to go by helicopter. They had to have the life flight team transport her, but she was taken by ambulance from Riverton to Primary's.
I got to ride in the ambulance with her. That was really neat actually. I work at AMRG and what I do is I dispatch for life flight and we do inter-facility transfers. From one hospital to another that gives a higher level of care....exactly what was happening to us. I chatted with the ambulance driver the whole way there about what their response times are, and I found out that he actually just picked up one of my crews a few days earlier who was bringing a patient to the University hospital. It was neat to actually see what goes on on the other end of the phone call....but it sucked that that's the way I had to experience it.
When we got to Primary's, they took us straight to the PICU. They were waiting for us, so as soon as we got there, they all came in and did their assessment. The chest x-ray they took when we first got at Primary's was way way WAY worse than the original x-ray that was taken at Riverton. The x-ray should show the area in your lungs are black...that means they're clear. Baby's x-ray showed almost no black at all....it was completely white, that was NOT good. They immediately took the mask off of her and put her on high flow at 6L @ 70%. Finally she was able to calm down from all the commotion and get some sleep.
When we got to Primary's, they took us straight to the PICU. They were waiting for us, so as soon as we got there, they all came in and did their assessment. The chest x-ray they took when we first got at Primary's was way way WAY worse than the original x-ray that was taken at Riverton. The x-ray should show the area in your lungs are black...that means they're clear. Baby's x-ray showed almost no black at all....it was completely white, that was NOT good. They immediately took the mask off of her and put her on high flow at 6L @ 70%. Finally she was able to calm down from all the commotion and get some sleep.
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