While I have your attention...

[FightingForFaith]

I've been meaning to get on the boards and ask this question for a while- so while I am thinking about it here it goes:

Faith has been sleeping on her stomach a lot lately (which is a milestone in itself- up until now she loathed her stomach) but consequently has been popping off the vent at the trach and the T. What scares me is the vent does not always alarm when this happens if it's pushed up against something like the mattress or her clothes. When we were in the hospital we heard a story of a little boy passing away because of this.

I am not worried that I won't hear it- I can hear the difference in the vent a mile away. It's when we are NOT around that scares me. The last time we had a night nurse we found her sleeping on the couch, lights off, with a pillow over her head (no kidding). A year ago this week Faith almost died because she became disconnected and a nurse did not know what do. I can't help but think of something like that happening again.

When Faith sleeps she is on a pulse-ox which would alarm if she were in trouble but I am not putting all my eggs in that basket!

So I guess my question is- can I increase the sensitivity of the alarms without driving us all nuts with frequent, false alarms? Right now her high pressure vol. is set at 65, low pressure at 10 and the low minute volume is not set at anything.

Any other ideas?
Thanks!
Jen :)

[Ann]

Jen,
I'm not sure if changing the sensitivity of the alarms will resolve the issue of the vent not alarming if it's off but pushed against something. I think the pulse-ox is your front line and best defense against a vent disconnect. I don't have any ideas because my kid doesn't move. :)

[TommysDad]

Jen,

I'd have to agree with Ann. If the vent pops off and is pushed up against something, I don't think changing alarm settings is going to help you much. Having said that, when Tommy's sensitivity used to be set to 1, and we would pop him off and put an artifical lung over the vent to suction Tommy, the vent would go wild with low minute volume alarms. As soon as his sensitivity got upped to 3, we do not have that problem. But to change one's sensitivities on your own is not something I would feel comfortable doing with out talking to Pulmonolgy first. (Yet in a hospital, Tommy's RT's say they are allowed to change sensitivities without DR's Orders:confused:)

Also, do you use anything to keep the vent connected to the trach besides just the swivil adaptor or T as you call it? Tommy kept popping off his vent ALL the time in the hospital! An RT showed us how to use an extra trach tie and a rubber band to keep the vent on and to help minimalize popping off his vent. This still isn't a 100%, but it does help us A LOT!!! Tommy flips around like a pancake in bed:D

I'm scared of that same thing happening (or nurses just silencing alarms and doing nothing but that), and I've heard those terrible stories, too! We keep a baby video monitor in Tommy's room for those very reasons!

FYI...Tommy's internal LPP alarm is=All Breaths. His High Pressure Alarm is set at 45, Low Pressure at 10, and Low Min. Volume as low as it can go at 0.1

[Alex's mom]

Are you able to change the setting for Low Minute Volume? We have ours set at 0.1. I don't know how much of a leak Faith has and if having the LMV set would cause a false alarm, but you could always play around w/it. Test it to see if it would alarm while disconnected, but pushed up against something.

I remember posting about this a few months ago. Here is the link:

http://www.tracheostomy.com/forum/showthread.php?t=16476

Good luck!

[FightingForFaith]

Faith does not really have a leak at all. :( Maybe that's why there isn't a # for LMV.

Ok guys, Pulse-ox it is. And trust. That's the one I'm having the hardest part with......but I guess having a child is all about letting go! :o Thanks for the input.

[lil' G's mom]

another thought is to use a "stronghold anti-disconnect device", can't find a picture of one, but it hooks on to trach and then velcro's around the elbow, G uses them and it works great, if he ever disconnects it's usually down at the acrodian extension.... he's learn to pull it off, or uses his feet to disconnect... LOL

[drct1245]

Hey Jen,
We too would use twill tape to tie around the swivel adapter to hold on just a little better. We used it around the clock - I think it help hold up the vent tubing too.

Our high pressure alarm was set at 45...? If she was on CPAP at night, then it would alarm... another reason to push for that. :D

Did you talk to your Doc further about it? Ever want a 2nd opinion, let me know and I will give you our pulm, whom we LOVE.

[FightingForFaith]

Hey Dawn- I'd love to get a second opp. but we are on an HMO and must "go" where they tell us. :rolleyes: Loved the zoo pics by the way. We need to get together sometime and go!

[Mom2TwinsPlus1]

We use a trach tie to hold ours one. Here is a video I did, really bad camera and lighting and I was horribly tired but you get the idea. We use dale trach ties but poseys or any other foam tie will work.
<object width="425" height="344"><param name="movie" value="http://www.youtube.com/v/CFAEalwyIMU&hl=en&fs=1"></param><param name="allowFullScreen" value="true"></param><embed src="http://www.youtube.com/v/CFAEalwyIMU&hl=en&fs=1" type="application/x-shockwave-flash" allowfullscreen="true" width="425" height="344"></embed></object>

Also we don't have a low min volume set on our vent since we are in SIMV mode, they told us we didn't need it. Ours alarms based off the low pressure alarm, which is set to 7. Pulmonetics recommends it be set 1 higher than the peep valve (our peep is at 6). Thankfully Emma is totally inactive and can't really knock her vent off, but this tie thing seems to help when I am pulling on her circuit to move her or readjust things