Mission: Extubate

Status: Complete

Ella’s doctor didn’t see a lot of the swelling go down overnight which is usually realized when you start to hear “baby noises”, though they did see some nostril flaring meaning that there was air leaking around her tube. With this information, the decision was made to extubate here. I wish I had a picture of this because there was equipment and tools and all sorts of medical equipment all over the place as a backup in case the extubation failed. When the nurses pulled the tube, she let out a good, hoarse cry, the first we’ve heard in a long time. It was a tense few minutes as the nurses frantically worked around her to get her mouth cleaned out and the nasal cannula installed, and the doctor and I stood in the back watching the O2 saturation level and heart rate. They also administered a quick dose of epinephrine mist in some of her first breaths to open her trachea and lungs. Finally, things started to get a little more stable and we could all hear her breathing quickly.

One of the recurring problems is that Ella is so strong and feisty. She really gives the nurses a hard time with her arms flailing and her legs kicking. They have had to get creative about restraining her and are constantly calming her when she wakes up upset.

Right now she is breathing through a cannula with 23% oxygen enriched air and is under a hood that is 80% Helium and 20% oxygen. The helium is used in place of nitrogen because it’s less dense, and is easier to breathe through a small space. She’s on a little bit of morphine right now to keep her calm. The nurses tried to soothe her for about 30 minutes, but finally relented and gave her some drugs. She’s much more calm now which makes me happy to know that she’s resting and not fighting the equipment thus risking further injury. They plan on giving her some milk later today to see how her digestive system is working. She only had a few cc’s of colostrum on her second day, and we are all anxious to get her eating. I am also really looking forward to holding her.