I had to resuscitate Oliver again yesterday morning. He was back to "normal" again immediately after the incident, but it wiped me out for the rest of the day. I took a long hard nap in the afternoon!
The trouble happened while were changing the ties that hold his trach tube in place. We change the ties and wash his neck daily and we always take precautions to prevent the tube from coming out while the ties are off, but this time it slipped out and he did not recover easily. The details are below for those interested:
I had already removed the old ties, cleaned his neck, put new ties and foam on, and was trying to tighten the velcro tabs around his neck when the nurse said his color wasn't good. I laid his head back down saw that his face was indeed turning dusky purple. We soon realized that his tracheostomy tube had come out; we didn't notice it previously because by that point I had put the new lyofoam piece around the trach tube so we couldn't see the trach tube underneath it. Our nurse was holding the trach tube in place, but Oliver was being especially squirmy in spite of being swaddled. The ventilator alarm did not go off, probably because the tube was being pressed against his neck still as the nurse thought she was still holding it in place, so there was enough resistance in the tube that the ventilator machine still acted as though it was attached to a patient.
Thankfully I was able to immediately put the trach tube back in easily on the first try (Oliver's tube is flexible so usually it requires another tool to put it in easily) and we quickly started "bagging" him (using a football-shaped balloon-looking device that lets us give Oliver manual breaths through his trach.- the "PR," or pulmonary resuscitation, part of "CPR"). His color worsened, turning to a mottled blue, and his vitals (heart rate and oxygen saturation) kept dropping on the monitor. I waited for him to revive for as long as I felt comfortable and then had the nurse call 911. While she talked to the dispatcher I did two brief sets of chest compressions because by now the oximeter probe had lost his pulse so monitor was just blinking. I kept praying, "Please, Lord, not while Joel's away, not now, not yet..." Shortly after the second set of chest compressions he suddenly turned pink and started squirming again.
We welcomed the paramedics a few moments later. Even though Oliver was back to normal again by the time they arrived, I was still thankful for them assess him and check to make sure I had not damaged his sternum or other parts of his chest when I did the compressions. They did not detect any obvious damage, and I was reassured later in the day when I spoke to our pediatrician that it is very unlikely that I caused any damage because he is still so young and his bones are still soft and somewhat pliable.
I am so thankful that we had a friend helping us with the girls that morning. As soon as Oliver was stable I went into the other room explained what happened, and then let them come into the living room to watch the paramedics arrive and check Oliver. Nora hung back at a distance with our friend, but Elsa found the whole situation very interesting and I had to ask her just watch quietly because she wanted to keep talking to the paramedics!
Joel has been out of town for work this week, so I am especially thankful that Oliver pulled through ok again. Thank you, again and as always, for your on-going prayers, support, and encouragement.
The trouble happened while were changing the ties that hold his trach tube in place. We change the ties and wash his neck daily and we always take precautions to prevent the tube from coming out while the ties are off, but this time it slipped out and he did not recover easily. The details are below for those interested:
I had already removed the old ties, cleaned his neck, put new ties and foam on, and was trying to tighten the velcro tabs around his neck when the nurse said his color wasn't good. I laid his head back down saw that his face was indeed turning dusky purple. We soon realized that his tracheostomy tube had come out; we didn't notice it previously because by that point I had put the new lyofoam piece around the trach tube so we couldn't see the trach tube underneath it. Our nurse was holding the trach tube in place, but Oliver was being especially squirmy in spite of being swaddled. The ventilator alarm did not go off, probably because the tube was being pressed against his neck still as the nurse thought she was still holding it in place, so there was enough resistance in the tube that the ventilator machine still acted as though it was attached to a patient.
Thankfully I was able to immediately put the trach tube back in easily on the first try (Oliver's tube is flexible so usually it requires another tool to put it in easily) and we quickly started "bagging" him (using a football-shaped balloon-looking device that lets us give Oliver manual breaths through his trach.- the "PR," or pulmonary resuscitation, part of "CPR"). His color worsened, turning to a mottled blue, and his vitals (heart rate and oxygen saturation) kept dropping on the monitor. I waited for him to revive for as long as I felt comfortable and then had the nurse call 911. While she talked to the dispatcher I did two brief sets of chest compressions because by now the oximeter probe had lost his pulse so monitor was just blinking. I kept praying, "Please, Lord, not while Joel's away, not now, not yet..." Shortly after the second set of chest compressions he suddenly turned pink and started squirming again.
We welcomed the paramedics a few moments later. Even though Oliver was back to normal again by the time they arrived, I was still thankful for them assess him and check to make sure I had not damaged his sternum or other parts of his chest when I did the compressions. They did not detect any obvious damage, and I was reassured later in the day when I spoke to our pediatrician that it is very unlikely that I caused any damage because he is still so young and his bones are still soft and somewhat pliable.
I am so thankful that we had a friend helping us with the girls that morning. As soon as Oliver was stable I went into the other room explained what happened, and then let them come into the living room to watch the paramedics arrive and check Oliver. Nora hung back at a distance with our friend, but Elsa found the whole situation very interesting and I had to ask her just watch quietly because she wanted to keep talking to the paramedics!
Joel has been out of town for work this week, so I am especially thankful that Oliver pulled through ok again. Thank you, again and as always, for your on-going prayers, support, and encouragement.
I read this after it happened but didn't know how to respond. THANKFUL, as always, that God spared Oliver for more space of time here with you and THANKFUL that He gives you reserves of unimaginable strength when you need it.
ReplyDeleteI continue to pray for Oliver and your entire family.