Saturday, September 13, 2008

Kiera Finally Did It...she decanulated! Whee! we know how that works. Definitely, Kiera's new found mobility is in direct conflict with her 3 foot ventilator circuit and vent stand too heavy for her to pull with her. She was at the rope limit and stretching to get something (that she shouldn't). She toppled, decanulated (ie. trach tube popped out, inflated balloon and all), unplugged SAT probe (so I'm not sure if or how low she desatted), and pulled out her G-tube (again balloon inflated), all simultaneously. It probably only took about a minute to get her recovered (maybe 2), but it seemed like longer. The obturator on hand that came with her trach seemed like a good one; however, in this type emergent situation, it bent and made things particularly difficult. There was lots of blood everywhere from the decanulation which made it look scarier. I don't think her SAT's were ever too too low, but since her plug to her probe had come undone I can't be certain. Her lips didn't get too dusky though, so I suppose maybe her SAT's dipped to 80's or perhaps 70's. Of course, she was crying and pissed off which made her red in the face, so that might have been hard to read. The best part was I got to do this by myself. Jer was at work. I did have one of my consultants here who I asked to help hold her hands down, although in the scurry to help I had the trach back in by the time she got to our side. That was certainly an initiation into the wonderful world of a toddler with a trachiostomy. Poor thing (my consultant) got to witness some colorful language on my part to say the least. I was fairly calm and collected until Kiera started fighting me and the obturator was bending. Then foul language seemed the appropriate response to get us through it. :) I am yet again aware of how skilled my nurses need to be. I am so glad to have the PICU nurses that I have because this is risky business.

On a lighter note: Kiera's mouthing of the word "Hi" has seemed to evolve into sticking her tongue out while saying it...kind of in Gene Simmons fashion or like an "Ack" from Bill the Cat. It's pretty funny. She's signing a lot more now too, and loves playing "This Little Piggy." She hands you her toes as if to get a pedicure.

Kiera also had a hearing screening yesterday and did pretty well. She shows a slight hearing loss in her left ear, but that may be attributed to the margin for error, so we just watch it and go back in 6 months. As it is, it wouldn't be something to correct anyway. She definitely fought like a bear to keep them from putting anything in her ears. She would have fought less had we been pulling off her toenails.


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