Day 247 - Vent Heater Settings & Too Much G-tube Output
Friday, September 3rd, 2021
Overall Today's Changes:
- Discontinued Robinul
- Increased vent heater to "2 dots"
- Received 3% nebulizer treatment
- Increased erythromycin to 3x a day; 9am, 3pm, 9pm
- Gastric drainage output from G-tube over 322ml in 24 hrs
- Increased feeds buy 1ml every 12 hours
New admit nextdoor again, young boy last night screamed for his life for several hours. You can't sleep hearing a child scream and cry. Well James can, he's used to it. But lord, what a night.
Still no access to the Hospital portal to obtain James medical records. It's been over a week to get access. The issue is the names don't match up. When James was born he was under mom's name with a "-Boy" next to it. It was like this for 8 months. But now being reamitted, he's under James and it's throwing everybody off. Which means that his first 8 months of records is going to be under a separate account, and now they need to create a second account. There should be someone who's pretty tech savvy that should be able to merge these but we understand it's not anyone's priority right now. Still frustrating when your baby has an x-ray, echo, or blood drawn and you want to see the results fast. Sometimes the nurse will tell you but a lot of times they won't. You have to ask and then their response is typically, "well technically I can't interpret the results, we need to ask the doctor". The portal is also a really easy way to keep track of numbers like input and output summary for weighed diapers and gastric drainage amount, a quick glance for active medications and dosage amounts, and clinical notes from Doctors. None of this we have access to right now. ☹️
Figuring Out the Home Vent Heater
We have a pretty crappy heater from our DME. There is no way to tell what temperature it is except for three little dots. We are guessing that 1 is low and 3 is high. Well when we were home we had it on 3, because that's what we were told to do and James had rainout two nights in a row. Again rainout is when condensation builds up in the circuit tubing so much that there are waves of water rushing back and forth in the tubing as he breathes. One movement with his arm when he stretches and this water goes right down his trach and drowns him. The LTV ventilator is known for having a wet circuit.
Last night we had his heater on 1 for; no secretions, which isn't a good thing. A couple of times he was agitated but Mom couldn't feel or hear any secretions. She still suctioned and the had thick ones that were stuck, only came through with a saline bullet flush. We are concerned about muscus plugs, so we are stopping Robinul (which thickens secretions) and also going up to 2 dots on the heater which will add back humidity. At noon, we gave him a 3% hypertonic sodium chloride treatment to help him if he is dried out. It is a salty solution that helps to hydrate the airways and thin the mucus in the lungs. Hydrating the airways helps the respiratory tract move the mucus from the lungs.
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