They used the E word (extubation)!

I almost fell out of my chair this evening during the attending hand off rounds when Dr. O told Drs. E&B they are thinking Elliott will be extubated the day after tomorrow! Previously, our only extubation timelines were rough estimates made by seasoned nurses. This is enormously exciting! We will have to see if our little E is up for sticking to a timeline for his big E! Oh, please Elliott! Please play nicely! Momma wants to hold you in her arms and nuzzle your soft baby head!

Apologies for the lack of promised pictures in the previous post. There is an issue with the site that is kicking back my posts and I figured out that if I take out the pics, the posts will upload. I'll add pics as soon as the bug is resolved.

Elliott's feeds have increased to 20 cc per hour, and his TPN has been dc'd. He has tolerated all of the vent weaning steps taken today. His fio2 is at 40%, rate is down to 20, peep is at 5, and p1 is at 13. All excellent steps in the right direction! His blood gases look good, chemistries look good (potassium was a tad low, so they gave him a boost).

I'm not sure if I told you, but his pacer wired were removed this morning. Hey were set to remove the central line as well. I pointed out that he would have to have heel sticks to get blood if they removed the central fem line.
The thought was that they would use the PICC line for blood draws. Unfortunately, he has a neoPICC line and it is too small to draw back on for blood draws. They double checked me, which I appreciate as I am not an expert, and found that the neoPICC is, indeed, too small to draw back on. I am really glad I spoke up. If you haven't seen someone try to draw blood for 2-4 hour blood gases from a baby, it is a sight that would make the hardest of hearts wince. It is literally like drawing blood from a stone, from a sweet, pink, sobbing stone with tears streaming down it's face. It's just terrible.

Hopefully, we will have a good night. Elliott will continue to move forward and tomorrow we can bid a sweet farewell to the pd catheter, and see good vent weaning pressure trials!

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