Tuesday, May 27th

Kathy and I did not have the fastest start to our morning. Kathy was extremely sore and had a difficult time moving around. A few ibuprofen helped a bit and we ended up arriving back at Children's Mercy around 10:15 am.

Kinley has a new nurse today, Dorothy, and she gave us an update of Kinley's activities through last night. Apparently, soon after we left yesterday Kinley was placed on NO2 (nitrous oxide). NO2 is a pulmonary vasodialator and it helps decrease the pressure in the lungs, which in turn helps the blood flow to the lungs since blood will always move towards the lowest pressure. The reason they started NO2 is because her O2 had dropped to 70. After getting Kinley onto NO2 they also gave her a dose of hydrocortisone to help increase her peripheral BP.

As of this morning Kinley's CO2 level is a little high and therefore her Ph is a little low. Her O2 levels are looking really good due to the help from the NO2. Kinley's mid-day was pretty uneventful. At 3 pm we did a blood gas test. This one looked really good. Her Ph was 7.38, her CO2 was 35 and her O2 was 214. From here Kinley continued her day of uneventfulness and around 6:45 pm we ran another blood gas. This one was another good one. Her Ph was 7.35, her CO2 was 44.5 and her O2 was 128. The numbers may not look as impressive as her previous test, but these were really good results. Shift change is coming up. Kathy and I have decided to eat dinner at the cafeteria and stay with Kinley for a while during the night shift.

After dinner Kathy and I came back to meet Kinley's nurse for the night, Noel. Noel was Kinley's nurse last night also, but we did not get to spend much time with her since we went home during the shift change. As always, Kinley's BP was low and around 9:40 pm they ordered 2 doses of hydrocortisone to try and help raise her peripheral BP. The plan was for one dose to be given now and the other in 8 hours. Before the order of hydrocortisone arrived we ran another blood gas test. The results came back with Kinley's Ph being 7.4, her CO2 at 37 and her O2 at 165. Both the doctor and Noel agreed that since Kinley's numbers were good, even with her low BP, that they would not give her the doses of hydrocortisone. In fact, they decided to drop her vent settings from 36 to 35. This should help increase her CO2 levels. It is not a drastic change, but remember how much a 2% change in oxygen settings affected her before. (If you can't remember, it dropped her O2 levels by 120.) As I have read in Sofie's blog and others, many of the changes that will be made to Kinley's care will be minuscule, but very important. They will plan on doing another blood gas at midnight, but we are getting pretty tired and will head home for some shut eye.