[Enzo] Day 20 report
- From: Kelly Groves <kelly@xxxxxxxxx>
- To: "enzo@xxxxxxxxxxxxx" <enzo@xxxxxxxxxxxxx>
- Date: Thu, 1 May 2014 21:54:15 -0700
Day 20
Doctor: Anna Marie S.
Nurses: Amber (night), Penny (day)
Gestational age: 31 5/7 weeks
Weight: 1306 g
Length: not measured
FiO2: 30%
Flow: 2 LPM on HFNC
Feeding: 25 ml Q 3 hr. (24 cal breast milk with liquid protein added.) through
NG tube. PO multivitamin and caffeine.
Other issues: left lung ongoing PIE
Other notes: resting mostly on left side or prone, little to no residuals,
elimination good.
Another quiet, stable day today. Yes!
Amber had trouble with Enzo de-satting during feedings overnight. They had to
increase his FiO2 to 60% at times. The rest of the time he was fine at 40%. It
would be much better if we could increase the flow, but we don't want to risk
another pneumothorax. The de-satting continued through his morning feedings.
Penny is new to Enzo and took her time getting to know him and us, even though
she was crazy busy with a new patient being admitted. She eventually got Enzo
weaned to under 30% FiO2 through careful monitoring. We were quite impressed.
Before going off shift (at 8:30 am), Dr. Bob ordered for Enzo's OG tube to be
switched for an NG tube (through his nose, rather than his mouth) to aid the
nippling practice. That happened before his 2pm meal. In spite of occasional
sneezing, Enzo seems much more comfy with the new setup. In fact, the A's and
B's we've been seeing could be related to the OG tube triggering his gag
reflex.
Similar patterns of holding during feedings today. He started out nippling a
tiny bit at his 8 am feeding, but quickly fell asleep. So, Mom went off to pump
while Dad held him. At his 2 o'clock, he started trying to figure out the whole
nursing thing in earnest. It's still far from coordinated, but he's definitely
got the right idea and is making progress. There were even a couple of solid
latches followed by a series of enthusiastic suckling. He's gonna get there as
long as we're patient.
The noisy babies were moved away from Enzo overnight, and he just got a new
neighbor this morning, named Seric. He's small, too, but still way bigger than
Baby Enzo, by at least 400g. He sounds like a bleating lamb most of the time,
but seemed to have worn himself out by mid afternoon.
Amber and Penny are both back tonight and tomorrow, and we're looking forward
to another good day with steady progress.
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