View Full Version : Something odd happened this morning
08-07-2008, 02:16 AM
The nurse left at 7am as usual, she said he was very settled and only suctioned him once. Heard him stirring as soon as I shut the door after her and went into him. He was breathing really oddly, not with difficulty it just sounded completley different, very raspy and not coming from the trachi.
Took the humidified air attachment off and realised he was breathing through his mouth!!! Went to suction him striaghtaway but no suction sound so realised is his tube was plugged:eek: (after I mentioned it in another post only recently and this is the first time its happened). If his sats weren't 97 I would have done an emergency trach change. Anyway, on goes neb and he's happy as, coughing up the gunk. Not sure what to think, feel funny mentioning to ENT in fear of feeling foolish (and desperate.... which i am i guess:blush: )
Has this happened to anyone?
08-07-2008, 02:35 AM
It hasn't happened to me to the degree you described, but has happened to friends of ours. Despite the sats, as soon as you have a second person, I would change the trach anyway. If you get a plug that bad, the cannula is probably lined with gunk, and it is a tough airway anyway.
Have you checked the humidifier to be sure it was still working right toward morning? That is how we get plugs -- when the humidifier water runs out or the bottle attachment comes loose a little bit and the mist doesn't flow properly. If this is the case, thick secretions can happen. Just keep nebbing, and I would think it would pass.
Keep us posted.
08-07-2008, 07:10 AM
We had similar things happen to us prior to decann, especially in the months or so right before. Not plugs, Kate had maybe 2 plugs the entire time she was trached...but she would somehow get the trach out and we wouldn't know it because her color would be fine and her sats as well. I don't think it's desperate. It's good for your ENT to know everything, so they get a bigger picture. I didn't mention these things to ENT before the surgery, but when he came out to tell us she didn't need the surgery I did. He didn't seem suprised at all.
I do agree with Karin though...change that trach, it may have dried thick secretions in it.
08-07-2008, 01:11 PM
Certainly gave a longneb and things loosened up pretty quick. I think what happened with the humidifier is that the water bag ran out completely before the nurse put up a new one. I usually change it before it runs out completely. He's been fine today, but have decided to definately mention it to ENT especially because of his history. Thanks for the input, its so helpful to get such instant info.
08-07-2008, 01:41 PM
Well, I'm not sure what to think about all that. On the one hand it's scary to think he got the plug but it's also reassuring to know he's okay breathing through his mouth, at least this time.
Back when Ainsley was on the warm-mist humififier collar all night we did occasionally have a situation where the nurse forgot to replace the bag and it blew dry air on her all night and she was think the next day. We don't do nebs but I was able to losen up the secretions using the saline bullets.
I think it's probably a good sign and is worthy of mention at your next appointment.
Good advice, but I'm wondering too about the nurse. Complete plugs like that don't happen, in my experience, quickly -- they take a while to form. Seems like the nurse should have picked up on that -- the water bag going dry and noisy breathing. Glad your little one could breathe through his mouth!!
08-07-2008, 02:21 PM
I agree with Hope... We have one nurse that "doesn't want to waste things" ie water, O2, etc. My thought is that it's not wasting when it's close to done, it's in the best interest of the child to refill before they need it! Unless you pay for things out of pocket, then that's a little different.
Glad all is well. Ayden has never been on a mist collar and has only used HME's along w/ his O2 and we have actually never had a plug or a partial plug.... so we have only the experience of the water heater on the vent.
I would definitely mention the experience to the ENT - if there is a plug, he is essentially capped! :)
08-08-2008, 10:43 AM
Complete plugs like that don't happen, in my experience, quickly -- they take a while to form.
Complete plugs out of the blue are Ciara's specialty despite extra hydration, humidification 16 to 20 hours/day and extra saline nebs. Karen
08-08-2008, 04:13 PM
Well, been extra vigilant about keeping secretions loose, quite a bit more today than yesterday and unusual amount of coughing for short periods of time and then nothing for a few hours (??) They're clear and he's in great from :) but he's had a temperature today:( My eldest had a viral something-or-other Monday-Wednesday; high temp, sore head and glassy eyed and off food. I'm kinda hoping that if K does have anything its a dose of what Conor had. His sats are fine (97-100) but just aware that he could be brewing something.
Emailed ENT nurse yesterday eve but no response yet (many don't work on Friday's as they've done so much overtime during the week:rolleyes: ) Anyway, orthotics apt on Monday so will pop in a see her then. I really need to keep my mobile neb machine-battery charged these days as even a few hours out, expecially with the PMV we need nebs on the move!
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