Friday, July 29, 2011

New Skill

Today Chris and I added a new skill to our home nursing repertoire: NG tube placement.  Poor baby coughed it up yet again this morning, so we decided that it was time we learned to replace it ourselves.  Her gag reflex seems stronger and is forcing it out, and we still need it to keep her hydrated, fed and medicated.  It is relatively easy and safe to do at home, and it saves us a trip to the hospital or emergency room.

Despite all of the things I have already had to learn (subcutaneous injections, wound care, bolus feedings, medication administration, port accessing, etc.), I have avoided this particular lesson for quite a while.  There is no part of forcing a tube through her nose to her stomach that excites me.  It is a two-parent job - one to hold her down, the other to feed the tube in.  At least we don't have to do it alone.

Luckily, it is not as hard as it seems.  My biggest concern is accidentally going into the lungs rather than the stomach.  The nurse basically said, yes, it can happen; if she turns blue and can't breath, pull the tube out and try again.  We always check the placement of the tube before feeding if it looks like it has moved by pushing in a small amount of air and listening for it in her stomach with a stethoscope.  Like my sister commented the other day, Scarlett's room is just a treasure trove of medical equipment at this point - stethoscopes, saline, syringes, sharps box, tape, adhesive remover, alcohol wipes and surgical scissors mixed in with the wipes and diaper cream. 

Despite the daily puke, Scarlett is starting to feel better, so this just fuels our eagerness to transition her back to some kind of normal eating schedule.  She currently eats very little formula during the day (and no purees while she is so gaggy), then gets pump feedings overnight, since she is less likely to throw up when she is sleeping.  Our goal is to begin increasing the amount she gets during the day - as much through bottles as we can, then with syringes - to give her that "full" feeling again, then gradually taper off the night feedings.  Hopefully this works - it will likely take a few weeks to months at least, so we are hoping we can start soon.

It's just another strange day in parenting for Chris and me. 


April said...

She is such a trooper & I commend you all for being so strong! I think of Scarlett so often when look at my little guy Silas who is the same age & say a little prayer for her..

Terri said...

Putting in NG tubes is one of the toughest skills I taught nursing students. Kudos to you guys for getting it done. Glad she's doing well overall.

April said...

Poor kiddo. You guys are really stepping up to take care of things. She's as lucky to have you as you are to have her.