human
2 year old respiratory distress?27 month old female, 27 lbs. Meds: duoneb, albuterol sulfate, epi pens. History: born at 31 weeks, required extensive oxygen support including ventilation for a few weeks. Allergies to eggs, peanuts, coconut, sunflower, dogs.2 year old is on day 3 of a relatively minor cold. She is covid negative as is the rest of the family (we tested for Christmas.) Over night started having a little trouble breathing. Resting resp. rate was between 36 and 40 breaths per minute. Grunting occasionally, minor retractions in rib cage and clavicle. No fever, no vomiting, normal energy all day prior. Normal appetite, normal diaper count. Gave duoneb breathing treatment and noticed slight improvement. (Resp rate went from 40 to 36 bpm.)Does this warrant an ER visit? With covid surging Im hesitant to bring a not yet vaccinated former preemie anywhere she could be exposed. My Childrens hospital offers an e visit option but I feel like this is something theyd need to see and or hear for themselves in person.
gpt
That resp rate is close to normal for her age. The concerning part is the grunting and retractions. That signals she's working hard to breathe. Given her medical history it would be a good idea to have her seen by a doctor. She may need a change to her baseline inhaled medications if she's dealing with a cold.
Im doing all of the above but will look into the 3M tape, thank you!
Hey there. Patience is key. Helping your 27 weeker who needs home oxygen is a marathon, not a sprint. The impact of BPD/CLD is going to take a while for her lungs to get to the point where she can be off oxygen entirely, and will affect her lungs for the rest of her childhood and to some degree her entire adult life.That being said, trust what your team is saying here. The alarm parameters are perfectly fine as a level for concern. In the NICU, we would only care about desats longer than 10-15 seconds; momentary dips are much more likely to mean nothing. If your team thinks shes ready for room air overnight, particularly given her vigorous attempts to pull the cannula off, I think thats a good sign.Let her alarm do the work. You shouldnt have to be staying up next to her like this. The alarm can tell you when shes going longer than 10 seconds in the 80s. These short blips dont matter as much. If it alarms, just keep track of how many alarms overnight youre having, how long, and the low number reached during the desat. The monitor should be tracking this for you.Its okay. You are doing so much hard work for your daughter right now and are asking a lot of really important questions about how to give her the best treatment and recovery; that shows me that you are taking great care of her. Just keep talking with your team and dont be afraid to ask to speak with them in between appointments if you feel like things are changing.