Experience Is Priceless

It turned out to be somewhat of a long night. After things were settled from the dilaudid incident, Cathy started to comment that things did not feel right. After ten weeks I have learned that when Cathy says that something is not right, things aren't right. The respiratory therapist caring for Cathy last night did not have the luxury of this knowledge nor the experience to listen to the patient. Throughout the night the RT kept reassuring Cathy that things were OK, her oxygen saturation was good, she just needed to relax. By 6:30 or 7 am this morning the RT was beginning to realize that things were not right. Cathy was undergoing distressed breathing and was asking to be put on the Bi-Pap. The RT began the process of hooking her up to the Bi-Pap. However, when it came time to insert the inner cannula into the trach (the connection needed between the trach and the ventilator), it would not go in. I do not want to be to critical of the RT, but at that moment she panicked and left to go get help. It seemed like forever, but it was probably a little less than 30 minutes of Cathy and I wondering where the help was. During the time she was seeking help, the RT must have realized it was time for shift change. So, she went "down to give a report to her replacement". Fortunately, the replacement RT was very experienced. Within a minute or two she had diagnosed a malfunction in the humidifier. Cathy had been receiving dry air since before she first started to feel things were wrong around mid-night. The dry air had not only dried out Cathy's sinuses, mouth and trachea, but had also dried out the trach passageway so the inner cannula would not slide in. A quick dash to the 'supply closet' to retrieve a new humidifier and the problem was solved.

By the time I left the hospital (just before 10 am) Cathy was relaxed, sitting up in the chair, smiling, breathing comfortably again, and still on the trach collar. As of this morning at 5 am, Cathy had been on the trach collar for 76 hours straight. I am happy that this streak was not broken this morning. More importantly, I am ecstatic that Cathy is under the care of an experienced respiratory therapist today.