Getting lots of inquiries...so here it is so far. Long night. The short of it....the new medicine was started at midnight to bridge Tucker from the adivan (which he loves and does well on but it makes he sleepy and he rides the vent--opposite of what we need during extibation time, so we have not be giving it). This drug, remifentnal, is used in surgery for anaesthesia...should have hit him as soon as it hit his veins...didnt. We went up and up on it, still not settling. We hit 4 mls per kilo, which was 32 mils per hour, and he started wigging out. Like he was seeing things around him, he didn't know who I was, his heart rate went way up in a matter of seconds. So we had to come off that drug and put another one on board. All during this (it is now 300 am) they are poking him trying to get an arterial line. We have to have one to measure his blood pressure in his vein and to drawl blood from as we are extibated to make sure his gases in his blood stream are good. I kid you not, 18 pokes!!!! Tucker had had it.
SO, the new drug finally kicked in at 430am....but not for long. At 700 they are in here, yet again, looking for somewhere to put an IV and to try the arterial line again. AWAKE!!! Finally at 10ish, Dr del nido came walking down the hallway...I grabbed him and gave him the run down of our night....Tucker is awake, shouldn't be once again!! SO, orders were given, Ketamine was given in his muscle (since the iv they did get this morning from the IV team blew) He is now comfortable (11am), the Attending is in here putting the arterial line in and Tucker is finally sedated enough to be still while he does it. (Dr Del nido is the MAN!!!)
So, the plan is to let him sit on the drug now which is supposed to be fast acting and fast going away as well. So, the plan is to do this thing...they will turn off the new drug and as soon as he wakes up the vent will be pulled. Tuck really needs to rest now, he was up all night with all of us and he needs to be ready for fight once more.
Prayers PLEASE!!!! He is such a fighter....
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