Lots Going On...
Well, Emma has had a busy day. First, Emma has been off medication for over two days, and everything appears to be fine so far. However, they did check her trach aspirate for bacteria. The doctors expected to find bacteria colonizing the tube, and they did... the same bacteria Emma was just fighting off. The doctors could treat w/ more antibiotics preemptively, but the chance of actually getting rid of all of the bacteria is about zero. So, because Emma's lungs seem to be doing well, they took another course of action.
The doctors have started weening Emma's ventilator settings at a bit faster rate in the hope of being able to get the breathing tube out of her throat before she can catch another infection. How quickly they will be able to do this depends completely on Emma... they have already turned her rate down 5 (from 35 to 30). In order for the doctors to feel comfortable putting Emma on nasal CPAP, she needs to have a rate of 10-20 and a pressure of ~ 20/6 or less (currently she is at 23/6). The doctors are going to consider doing another rate / pressure change this afternoon depending on how well Emma is doing. It is exciting to see the ventilator rates changing (and Emma handling it so far)... Liz and I are very exciting about the prospect of having the breathing tube out of her mouth.
In addition to that, Emma has had another change in her feeding schedule (although not one I was expecting today...). Emma had been getting fed 20ml / 2 hours, and every four hours she would get "cares" (aka - temperature, diaper change, nurse would listen to breathing sounds, etc). Emma has been "upgraded" to getting fed 30ml / 3 hours, and she will get the basic cares every time she eats. While it doesn't seem like a big deal, it is a sign that the nurses and doctors are comfortable with Emma's progress. (note... our request that they get Emma on an eating every six hours schedule was scoffed at... I had to ask).
Other fun stuff... Emma got a bath Monday night, the SCN / NICU is getting very full (I don't know if they'll be able to handle any more babies... they had A LOT of admissions yesterday), so the atmosphere of the unit is much different than a couple weeks ago when there was 1/3 of the babies there is today... Emma is 33 weeks gestationally today (and 9 weeks, 2 days since birth)...
So, this could be an exciting week coming up for Emma. Let's hope that her lungs can continue doing well and that she can stave off any infections so Emma can get her breathing tube out.
The doctors have started weening Emma's ventilator settings at a bit faster rate in the hope of being able to get the breathing tube out of her throat before she can catch another infection. How quickly they will be able to do this depends completely on Emma... they have already turned her rate down 5 (from 35 to 30). In order for the doctors to feel comfortable putting Emma on nasal CPAP, she needs to have a rate of 10-20 and a pressure of ~ 20/6 or less (currently she is at 23/6). The doctors are going to consider doing another rate / pressure change this afternoon depending on how well Emma is doing. It is exciting to see the ventilator rates changing (and Emma handling it so far)... Liz and I are very exciting about the prospect of having the breathing tube out of her mouth.
In addition to that, Emma has had another change in her feeding schedule (although not one I was expecting today...). Emma had been getting fed 20ml / 2 hours, and every four hours she would get "cares" (aka - temperature, diaper change, nurse would listen to breathing sounds, etc). Emma has been "upgraded" to getting fed 30ml / 3 hours, and she will get the basic cares every time she eats. While it doesn't seem like a big deal, it is a sign that the nurses and doctors are comfortable with Emma's progress. (note... our request that they get Emma on an eating every six hours schedule was scoffed at... I had to ask).
Other fun stuff... Emma got a bath Monday night, the SCN / NICU is getting very full (I don't know if they'll be able to handle any more babies... they had A LOT of admissions yesterday), so the atmosphere of the unit is much different than a couple weeks ago when there was 1/3 of the babies there is today... Emma is 33 weeks gestationally today (and 9 weeks, 2 days since birth)...
So, this could be an exciting week coming up for Emma. Let's hope that her lungs can continue doing well and that she can stave off any infections so Emma can get her breathing tube out.
posted by Chadwick at 4:21 PM
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