Saturday, November 20, 2010

Saturday evening

We had a relatively quiet day today, mostly still working on finding a good sedation plan for Emma Kate. She's done well overall and is mostly initiating her own breaths with the ventilator. At one point there was some worry about her prolonged expiratory phase, so they increased the PEEP on her ventilator to see if it would help. Later in the day she suddenly desaturated and the peak pressures on her vent went up. They also were hearing some wheezes in her lungs. They lavaged and suctioned her ET and gave her an albuterol treatment. They think it may have been a mucous plug, as it seems to have responded to the treatments and hasn't happened again since then. They also decided to reduce the PEEP back to where it was this morning. We were concerned about the right side of her lungs looking a little more dense on the xray they took, compared to the one they took this morning, but they don't seem to be concerned by it and are comfortable with where she is now.

She got another good bath today and had her hair cleaned nicely. She's still getting her PT and wearing her foot splints off and on through the day. She had a few nice quiet awake periods through the day, and seems to be very responsive to the sedatives, which is reassuring. Her urinary catheter was pulled late this morning, and we're going to be watching for her to pass urine on her own... it's likely to take a few days for her bladder sphincter to relax from having that catheter in there so long. Just another thing to agonize over!

We're likely to have a similar day tomorrow, at some point they'll start weaning her off the fentanyl and versed, and over the next few days they'll work to getting her to "extubatable settings" on her ventilator- sounds like we're not too far from that already.

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