Monday, March 4, 2013

Day4- 4am

Ugh...! Just ugh! :(
Little man is finally asleep. He's been fitful tonight - tough to get to sleep, not sleeping long. Around 2:30 am he cried out - went to him and he was eating his nasal cannula. No nurse in site even though his sats had dropped and he was agitated. Got his bottle and he slowly ate 1 ounce. The whole time he had his left leg pulled up to his belly... Just the left and he wasn't kicking it, just holding it tucked up. (He did the same thing last surgery when he had the PICC line in his right leg - it hurt him and he kept that leg bent and close to his body.) I knew something was hurting him on that side. Asked the nurse for more milk - they keep my breastmilk under lock and key- and a diff type of bottle to see if he could eat easier out of a DrBrowns. She brought everything in and I asked her to look at him - showed her his tucked leg. We checked his leg, foot, tummy... Nothing. Chalked it up to maybe that central chest tube hurting him. She left. He couldn't sleep. His pulse has been up for about 12 hours - in the 140s- 150s when they had been in the low 120s. No one was concerned as it falls in the normal range, but we knew this wasn't normal for him.
I heated his milk... 3:30 am. He's still awake and still tucking that leg up.
4 am getting agitated so I reposition him...rolling him on his right... Mindful of his RA wire, his chest tube, pulse ox, oxygen cannula, placed his left arm on his side - it was still wrapped and boarded from surgery - an arterial line and a PIV line with his fluids. His upper arm sticking out above the board was rock hard and twice normal size. I rushed for the nurse and she got the doc. His iv had gone bad and had been pumping all the fluid into the tissue of his arm, not his vein. It's a grade 4 - whatever that means to the docs. To me it means his hand and arm were purple and so swollen they felt made of stone. Cold stone and it had a bright white area like a big blister where the iv went in. It looked excruciating. We are having someone from ortho and plastics to look at it - see if there will be lasting damage.
They took out the iv but had to leave his arterial line in until after his chest tube and RA wire come out. I just want everything off that hand now! That was the hand he would chew on... And twirl his hair... And grab his ear in his sleep.
I feel awful the signs were there and I missed them... Please don't let him have lasting damage from this:(
I hate this. so mad at myself... And mad at the nurses... And myself again.

9 comments:

  1. Oh Sweetie I know you are upset, but you are the one who found it! It really stinks it wasn't discovered sooner, when you asked them to check, but, it was discovered! My prayer is that the fluid will absorb, that there won't be any lasting damage/impact from this event. Poor baby, makes me cry reading your words. So frustrated! For you, for him! I hope today is a better day! Love you!

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  2. I looked up intraveous complications to understand what grade 4 might mean and found a site (forum for nurses) discussing a similiar case. Check it out and see comments by a "Chris" regarding the scale of 1-5, and how they should measure circumfrance of limbs to PREVENT infiltration. If this is TMI/unwanted, let me know & I'll back off. Just trying to help! Love you!

    http://allnurses.com/infusion-nursing-intravenous/iv-infiltration-treatment-4315.html

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  3. Cold is good, means no infection!

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  4. If you had not been so aware, who knows what might have happened before the nurses noticed. A mother knows her child more than anyone else. Thank God you were so alert and aware. Keep up the good Mom vigilance, and with all of us praying with our vigilance, he will persevere. Know we are all here for you three!!!! Love, Grammy I still hurt when I know and see how much he has endured and still has more to go. We are all there to support you and pray!

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  5. Hey there, have they given you any more info? What medications were being pushed into the tissue? It is important to determine if the infusion was a "vesicant" or an
    "irritant."

    Infiltration = leak of fluid into extravascular tissue

    Extravasation = infiltration of a vesicant

    Vesicant = agent that causes blistering and/or
    tissue damage

    - you should be getting tons of information from the staff. Be sure you keep documenting everything they said/did and continue to document. I wish I was there [howling with frustration!]

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  6. no matter how vigilant we are, we can't catch everything. we are human. but you don't need to worry, because id bet anything in the world mom is there helping him through everything. she was a pediatric nurse after all and do you think a silly little thing like death is going to make her stop looking after children? I don't.

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  7. Don't beat yourself up like that kiddo - you are the one that finally found what was wrong, and got it taken care of. Prayers continue. Lots of love to all of you. Martha.

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  8. Uhh..How aweful. I always hated when things were on Blake's preferred hand too. So sad. Hopefully, tomorrow will be a better day. xoxo

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  9. he is twirling his hair..he is drinking his milk...he is. HE IS!!!!mum

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