I walked into the PICU after giving them an hour to place the chest tube to see about 10 people around her bed, looking like they were getting ready to intubate. My heart jumped into my throat and all I could see was the images from Tuesday running through my mind. Though Gracie wasn't coding I couldn't help but fear that she was heading in that direction.
Grace came within inches of needing to be intubated, but luckily didn't have to. Apparently what happened is that the chest tube placement went fine, but as they were getting an x-ray to make sure it was in a good place, Gracie's sats dropped and she wasn't breathing. When the RT bagged, no air was entering her lungs, she clamped down so hard that nothing could get through, eventually they opened her airway with this plastic piece and that seemed to help. She is doing well now---thankfully.
The doctors really don't know what happened, they speculate that the sedation wore off, Gracie woke up and got ticked off to find a chest tube in her side. She got mad, clamped down and possibly coughed up some thick secretions, which got stuck in her airway. About twenty minutes later she got mad, dropped her sats to 40 and the doctors were threatening CPAP. Luckily, an RT who knows Grace well extremely well told the nurses that usually less is more with Grace (meaning leave her alone unless she is in dire need of some attention). Basically Gracie needs to sleep and rest so she doesn't realize what happened. The fellow told them that though it seemed unorthodox, to put Gracie in her swing, since she is so happy in it. She has now been in her swing for almost an hour and her sats haven't dropped past 73.
I worry that when I leave there may be some issues with Gracie again, because even though I have told the nurses what to give Grace to keep her sleepy and happy, they were just talking about how they are going to try not to give her anything else until 5pm when her methadone is due. I'm giving Gracie a few minutes to show them what I have been trying to tell them before I insist that they give her some loratab or benedryl or something.
Such a simple procedure, yet Grace never ceases to surprise the doctors and keep them on their toes. The Attending said to Gracie that she doesn't have many more year to give Gracie, since she has already taken several off of her life :) Though it is frustrating at times, I'm thankful for Gracie's stubbornness and fiestiness, it is what keeps her going even if it adds some complications that we would rather not deal with.