Really. Can we catch a fuddruckin’ break? Seriously.
We had a bit of a scare yesterday night with Ryan’s oxygenation. After showering him and getting him in bed we rolled him onto his side to expose his butt rash to the air. Delighted in the fact that his blood pressure was normal, I completely overlooked his oxygen saturation until the monitor began alarming. It was screaming at us to pay attention. Well, I guess that teaches me NEVER to relax.
The monitor was flashing like crazy. Normally, I like being flashed, but this was not what I had in mind. Within a minute, his oxygen saturation dropped into the low to mid eighties. Not a safe level if it continues, but not quite a full-blown crisis… yet. In simple terms, oxygen saturation is the percentage of oxygen reaching tissues through the blood. One-hundred percent is ideal. When it gets below ninety-two percent there is not enough pressure to push oxygen into the red blood cells. Now the cells are beginning to starve of oxygen. Below eighty-eight percent is considered dangerous deprivation and must be resolved quickly.
So, I switched into “Doctor Mode”, barking out orders to the nurse and Sue (sorry, Sue). “I need the suction catheter and lubricating jelly. Get him on supplemental oxygen at ten liters. Roll him on his back and get him to forty degrees inclined. Prepared the nebulizer with a vial of albuterol and iprarropium. Start percussion therapy. Bring the cough assist machine. Give me a respiration count. Are his fingernail beds blue? See if he is invoking secondary muscles in his stomach to draw in more air.” Yep, I literally felt myself step out of my body. A technique that now comes naturally that separates me from the emotion of the moment.
Anyhow, we turned the situation around and his oxygen returned into the high nineties.Then, just like clockwork, the fear that I was holding at bay washed over me. Sure, nothing to be fearful of now, now that the crises was resolved… but strong emotions really don’t give a rat’s ass about timing.
I allowed my mind’s image of Vantrease and May in. The fear stepped aside for pure anger and disdain. Ahhh, this is better, I thought. Then, just for good measure, I included their families in my internal vision. What a terrible family portrait that made! I laughed at this thought.
Ryan eventually settled around ninety-five percent for the night. I’m still not sure what caused this, but suspect he had a mucus plug partially obstructing his airway.[poll id=”38″]