Tuesday, March 27, 2012

Exciting Night

I went to bed last night, fully expecting (or hoping?) to sleep well.  My rest was shattered when the nurse opened the door and exclaimed, "The vent isn't working and Aaron isn't breathing!'  Um, yeah, not a good scene.

I got out to his room to find William with him as the nurse finished hooking him to an ambu bag to force air into him.  She was bagging really fast, and his sats were continuing to drop.  I really don't know where they were at this point, but it wasn't pretty.  I took the bag from her, and instructed her to get the extra vent from behind the chair.  I also realized then that the bag wasn't hooked up to the oxygen, so we quickly fixed that.

He started looking a little better with some oxygen (imagine that) and a much slower bag.  William took over bagging while I helped the nurse get the new ventilator set up with a circuit and we plugged him in.

At that point, he was looking much better, and I started asking questions.  We discovered that it was more than likely that part of the circuit had come apart, but it was a small part, so she hadn't realized it.  Small, but enough that the air wasn't getting through to him.  So we set up another circuit to the original vent, put a test lung on it (really, just a heavy duty balloon), and it all tested just fine.  So back onto his original vent he went, and after giving me a grin, he went right back to sleep.

I said, good night, and went back to bed, too, but somehow, sleep didn't come so easy for me.  All I could think about was, what if it happened when I wasn't here.  I wasn't scared during the experience, but afterwards, it was hard to shut down.

During the excitement, I didn't even feel the adrenaline.  It was just, okay, do this, then this, then this.  Okay, it's all working.  Do we need an ambulance?  No, I don't think so.  We've got this under control. But, just for the record, 24 may be a great number if it's your age, but it's downright ugly if it's your oxygen saturation.  Yeah, we're supposed to hang out in the high 90s.  I'm told that pulse/ox machines aren't real accurate below 40%, but even a 40% is really, really bad.

So, today I spent putting together training materials.  I went looking for a picture of a ventilator and circuit set up so I could circle the places it might come apart.  With all the images on the internet, I couldn't find one!  So I made my own.  It's now in a place of honor right next to the ventilator.  I also put together a notebook with regular cares and emergency cares.  I'll be going through all of it with every nurse, and then marking off who has done what.  I've got some great nurses, but I have a hard time remembering who has been taught which part.  They do cover this all in nursing school, but I covered calculus, and I can't remember a thing about it.  And not much of physics or chemistry either.

But if I teach them, and we go over things hands on, I'll know and they'll know that they can handle things.  And they'll know when they're in over their heads as well and need to call for back-up.

So that's our quiet day.  But at least we're prepared now, I think.  And smart people may want to invest in Clairol.  I know I gained quite a few more gray hairs over this...

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