Friday-Sat update

Friday night was mostly uneventful until about 3am when Emma Kate's O2 sat dropped. From there it was an ongoing roller coaster through Saturday afternoon. She also suddenly had a large amount of red blood accumulate in the remaining chest drain. The source of the blood is undetermined. Chest films showed no fluid accumulation and the lungs looked good. Many meds were bolused to try to help, and the ventilator was adjusted several times. We ended up paralyzing her again to keep the ventilator breathing for her entirely and keeping positive pressure in her lungs. Then we got word from the radiologist that he thought her ET tube was down at her carina and needed to be adjusted. This made sense because Greg kept suggesting that she had better numbers on her ventilation when her neck was extended back, which would slightly shift the tube up her trachea. They pulled the tube back about 1.5cm and retaped it. Dr. Kirse (the ENT) came in (he was off duty!) and scoped her through the ET tube and said that the very tip of the tube was toward the pig bronchus, which might explain some of the difficulties we had while she was not paralyzed. They again repositioned the tube, retaped it, and checked it again with the scope. After that, she was fairly stable through the rest of the evening, and we decided that we would just keep her at the same place (paralyzed and sedated) and let her go through Sunday like that. Monday we plan to have the bronchoscope done and will have much more information after that. So for now (Sunday morning) we're just holding steady.