CPAP Day 2

We are starting on the second day of CPAP. Her blood gas this morning was 81. Still not very good. Her primary Patsy is at the helm today and she says she is not sure how long the doctor is going to let her hang out in the 80s. Does this mean she may go back on the vent? It is a possibility, but not necessarily.

Todd spent the night at Amelia's bedside last night and he saw the doctor very early this morning when he came in just to check on her (not part of rounds). He mentioned maybe putting her on epinephrin. I am not sure yet if this is in addition to or instead of the allbuterol. I know they kind of serve the same function, but I think epinephrin may be stronger. These are things I still have questions about. I know that I have taken epinephrin when I have a severe allergic reaction to cats. My throat constricts and the epinephrin opens up my lungs and throat. Perhaps this will allow Amelia to let go of her CO2 she is holding on to. Another option may be to increase the pressure on the CPAP. (note : she has a little wheezing going on, similar to an asthma wheeze, which is one reason they were thinking about the epinephrin. They don't know the source yet, but it's likely her throat is a little enflamed from the tube being stuck it for 95 days.)

Amelia is breathing easily on the CPAP and is satting pretty well. She is getting used to the appartus, which surely must be annoying with the head strap and the prongs up the nose. (her blood pressure is down today from yesterday, and she doesn't cry immediately when she sees the new stuff on her face.) All will be revealed at rounds and I will update you on what they decide. (note: her O2 needs are a little higher than what they were last night, but not overly. It might be a sign of her tiring, or of the effect of whatever is causing her wheeze.

UPDATE 9:56PM: The doctor has decided to throw blood gases out the window. No more using it as a barometer for anything. He is just going to look at Amelia to decide what to do next. If she is breathing normally without a bunch of panting, labored b reaths and if she keeps her sats up, she will stay on CPAP. Since she was doing all of that at rounds, he is keeping her where she is. If she is still tolerating her settings on day three, he will wean the pressure on her CPAP down to 7. A CPAP of 5 gets her off of CPAP and onto nasal cannula.

She is at 4 lbs. 10 oz. tonight. Her nightime primary Erica says that she is satting in the high 80s, breathing easily on 45% oxygen and is sleeping like a rock on her tummy.