Happy 2nd Birthday Baby Brandt!

Happy 2nd Birthday Baby Brandt!
Busy as can Be--2 Years Old!

Wednesday, December 8, 2010

Brandt decides to extubate himself!

Feisty B just extubated himself. If he breathes ok they'll leave it. If not they'll have 2 put him under again. BP is too high.
I posted this from my phone after we got back from supper and tried to go in to see Brandt again. Glenn's family was leaving to head home, and we were hurrying back to ICU to get the report from Brandt's nurse before she left for shift change. When we left him before supper, he had been restless and the pain and sedation drugs weren't preventing his discomfort or squirming. His nurse was trying different combinations that would allow him to come out of the anesthesia and be alert enough to continue breathing over the vent but prevent pain and too much movement. They had also restrained one of his arms.

So imagine our shock when we got to ICU and they would not let us in. The cardiologist on duty appeared at the door, which kind of scared us but he let us know very quickly that things were under control. However, just a few minutes previously Brandt had gotten really upset and pulled his tube out! I wasn't quite sure which tube they were referring to so we quickly clarified, "You mean he EXTUBATED himself?!?" And he agreed that indeed, Brandt had pulled the breathing tube out on his own. Apparently, from what his nurse told us, he had continued restless and she had restrained both arms, so he reared his little head back and used his tongue to push the tube out of place. He was breathing ok at that point, but they were concerned because they had just given him a big dose of pain medicine in addition to the anesthesia still in him. Plus they would normally clean up all his secretions and do c-pap trials to make sure he was ok to breath on his own before attempting to extubate!

So they told us it would be about 10 or 15 mins before we heard anything. 30 to 45 mins later I went back to the ICU to find out why we hadn't heard anything, and they were having a really rough time getting him calmed down. He was still breathing ok, but his blood pressure had gone through the roof, so the nurse let us know they would be starting an IV sedation drug called precedex on top of the other pain and calming meds they were already giving him. Because he was flailing around so much, they also had to restrain his arms and legs as they were concerned he could pull out his chest drainage tube or lines going to his heart. They said we could come in and see him after an hour as long as we didn't talk or touch him since our voices could easily rile him up again. The biggest challenge was to calm him without putting him out so much that he couldn't breath on his own and they would have to reintubate him.

We were very concerned at this point--as many people commented to us, "He's a fighter!" His nurse was pretty upset that he had done that "on her watch," but we had seen how closely she was monitoring everything and of course didn't mind him being off the vent early as long as he hadn't injured anything or slowed his other recovery. I told her his cardiologist at home said he has a sassy attitude but she said that would have to be sassy to the second degree! She also let us know he would have a nurse all to himself through the night, so that was encouraging.

She was finishing her shift and we thought it was really nice she came to see us before she left for the evening and let us know they had finally gotten him calmed down. We were so relieved to hear that, and then when we could get in to see him again, he was stabilized again. We didn't stay much later after that since they really didn't want talking around him, but his night nurse reassured us that she would call if he had any change for the worse.

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