There wasn’t much new in Emerson’s condition or support today.
We did a breathing trial on the vent to test her lungs in preparation for hopeful extubation, but she failed. We also had to go up on vent settings. Her lungs sound “okay” though &, given that, plans are to move forward with pulling the tube.
It has become nearly impossible to keep Emerson properly sedated. The number & dosage of meds she’s on is alarmingly high for her size and she’s still breaking through. While awake and thrashing, though, she is riding the vent. It’s very strange & no one is quite sure what to make of it – she has enough energy to throw herself off the bed, but not enough energy to breathe. We lowered her vent settings to more or less force her to breathe, but she was unable to adequately maintain her respiratory status and we had to increase mechanical support.
There is a theory that perhaps she isn’t ‘waking up’, but rather displaying moments of psychosis. I’m not sure; amidst flailing her arms & legs and grabbing for her tube, I can ask her questions and she will nod her head “yes” or “no” appropriately. I don’t know what’s going on, and everyone here is more or less postulating at this point because they don’t either. Concerns and hesitations aside, we are going to attempt to extubate to c-pap tomorrow.