Ruby Hope McKee Starling

Holly might have a different take on this, but Ruby had a good day today with the exception of a little episode caused by equipment malfunction and/or operator error.  I was at our apartment working all day, so I missed the excitement, but something happened with Ruby's ventilator that caused it to think she needed to be breathing at 100 breaths per minute.  This happened immediately after a respiratory therapist came by to re-calibrate the ventilator's flow sensor.  The RT thought that Ruby was being tachypneic (breathing too fast on her own) and the nurse thought the vent was auto-cycling (thinking that each exhale is an inhale).  Apparently Ruby got a fentanyl rescue before the nurse finally just disconnected Ruby from the ventilator briefly to prove that she would go back to breathing at a normal rate.  So for a few moments Ruby was breathing on her own this afternoon and did really well at it.  Her oxygen saturation didn't stay steady, but the poor girl was still breathing through an endotracheal tube and had just had a machine freak out on her.  After that, the RT replace Ruby's flow sensor and her ventilator let her go back to normal breathing. 

Watching all of this really shook up Holly.  It probably would have freaked me out a little too.  But the silver lining here is that we know Ruby can breathe on her own a little now. 

Ruby is still breathing 21% O2 -- "room air".    They reduced her morphine from 250 to 220.  Versed is at 200, I believe, and it will be reduced tomorrow.  The ventilator is set to give her 20 breaths per minute now, down from 25, and she's doing the rest of the breathing on her own the other half of  the time.  Her feeds went up to 20ml today, too.  So she's getting 160ml total per day now, in addition to her IV food. 

Well, I'm dozing off as I writre this so I'd better hit the sack and get some rest.