Sunday, September 22, 2013

ER night #2

So much for an easy second night. ER was far more crowded and we were less of a priority for night 2.  I wish that were the least of our problems.

The calm before the storm
As I said, on our first in the ER they decided to leave Logan's port accessed so that he didn't have to go through a traumatic access again. Around 2:00 this afternoon, Ryan noticed that Logan's access looked crooked, like it had bent or moved or something. I called the on-call number to see if it was something to be concerned about and she stated as long as it wasn't hurting him or leaking, they could deal with it when he came in at night. We moved on with the day and heading out to the hospital around 7:00. 

Once there, we had a relatively short wait and, expecting a short and pain-free visit, got back to a room. BTW, temperature at this point was downgraded to low-grade.   Met with some of the doctors and nurses and got the rundown for the night. I made sure to let them all know that something had happened to his access and that it was likely out of place.  The plan was to see if it was still working and, if necessary unaccess and reaccessed him.  

Here is where things got difficult. The nurse first attempted to draw blood for his labs from his access.  For those who don't know how this works, they attach an empty syringe to the end of the line and pull out the plunger to pull the blood out of the body. When his tried to pull the blood, nothing came out. Sometimes ports and get plugged or clotted if the blood starts to coagulate. Thinking this, the nurse continued to pull at the access with no luck.  The next trick is to push some saline through to try to unblock the line.  This is where things get ugly.  The nurse pushed a syringe of saline hoping to unblock the line, only to be meet with shrill screams from Logan.  It was clear something was wrong with the access.  An additional nurse was called and they tried to change positions.  They continued to pull at the line, hoping to draw the blood.  They started to move the access around hoping to reposition it without having to unaccess him completely, all the while Logan kicking and screaming.  Finally, they gave up and it was time to unaccess and start from scratch.  When the bandage was removed, the access practically fell off, meaning it had been dislodged the whole time.  All the the fluid that had been push, was pushed, not into his veins, but into his skin. All the moving and turning of the access, was digging a needle further into his flesh.  

Once the old access was out, we still had to get a new access in.  One more big needle stick and the new access was in. Problem solved right?  Almost.  With the new access in, it was time to get the blood draw.  As the nurse pulled on the line, still no blood came out.  A couple more minutes of trying and it was time to try the saline push again.  One big push of saline and FINALLY the line was clear! One hour of poking, prodding, crying, screaming. One hour of being pinned down while nurses hurt him. One hour of torture for a 3 year old.  And we still weren't anywhere near ready to go home. A few more minor glitches with the IV pump malfunctioning, and we were on to getting the antibiotic and waiting for the blood levels.  

Logan's attitude at this point was less then stellar. Rightfully so.  The next hour was a non-stop string of tantrums, whining and crying.  As justified as it was, it did not make it any easier to deal with. Labs came back ok and we were cleared to leave. One more moment of torture while we unaccessed him for the second time in one night. It was finally time to go home.  So far today, we have dealt with an endless sting of tantrums and screaming.  After a morning long battle, Logan got some of the extra sleep he desperately needed.  Fingers crossed for a relatively tantrum-free afternoon. 

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