[tri-med] Re: Chloral hydrate JUDE and anyone else who wnts to read. :)

----- Original Message ----- 
From: "Tammie Queen"
>I know first hand about the 02 sats as with Evan he always was in the 70's 
>because of his heart condition.  He also retained co2 alot towards the end 
>of his fight.

High capneic levels (CO2) is actually more dangerous than low O2. Capnea is 
a lot harder to monitor as well - its pretty much only done in ICU or high 
dependency units. Alex's new monitor has the capacity to monitor his CO2 
levels but I don't think I really want to know.

>> I always knew when his co2 was high because he would get agitated and he 
>> would have his eyes closed and shake his head back and forth.

Alex is the opposite - when his CO2 rises and his O2 drops he gets more and 
more lethargic. He has never woken himself because of apneas, in fact even 
now he tends to reposition himself during sleep so that he causes more 
apneas (chin down and on his left side). If Alex has an apnea I have always 
had to stimulate him to get him to take that next breath or he just wouldnt. 
Each child is different.

>>He also got chloral on several occasions.  For agitation when he was not 
>>on the vent.  The chloral did not seem to drop his 02 sats.

Very low doses of chloral shouldn't effect O2 levels but it certainly can. 
It can depress respiration - that is the depth and rate of breathing. If a 
child that has low toned airways (as many of our kids do) the reduction in 
positive airway pressure can be enough to cause the trachea to "stick" 
causing an apnea (obstructive). And it can depress the brains response to 
generate a breath causing a central apnea. Many of our kids are predisposed 
to this (central and / or obstructive apneas) so personally I wouldnt risk a 
CNS depressant unless there was a good reason and they were being very 
closely monitored with good facilities nearby.

That said Alex hasnt had a bad reaction to a CNS depressant since he was 12 
months old, even so no one wants to ever take the chance given his history 
and we avoid any CNS depressent like the plague.

Life consists not in holding good cards but in playing those you hold well.
                                            -- Josh Billings

Keep Looking For Rainbows!!
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 /Karen \
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          v Karen, Mum to Alex (12 years, T-18 Mosaic)
http://members.optushome.com.au/karens

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