Last night, there was some uproar about his Gtube site. It looked NASTY. Yellow and pus and red and swelling. The nurse was concerned, and the Resident was concerned and I was concerned. (Particularly because he had been running a fever.) And, honestly, I’d rather be safe than sorry.
She called a few people to come look at it. The resident from Peds Surgery who came was all grumpy and dismissive of our concerns. The nurse and resident persisted, and ended up deciding to do a few things. First, change the PD dressing. The surgeon punched a hole THROUGH the PD dressing to install the Gtube and, as a result, nobody could really adequately clean the site. Between the nurse, the resident, and myself, I was the only one there qualified to change the dressing, lol. So I did it. A little nerve-wracking doing it with a nurse and dr supervising, but I did great. Didn’t even violate my sterile field once.
Once I got that dressing out of their way, they were able to swab the pus and send it off for a culture, and then give the site a good scrubbing.
It looks much better this morning and the cultures came back fine.
Today, the new plans are:
– feeding. Turn off continuous feeds, and go to a minimum consumption goal. He has to take 90ccs every 4 hours during the day. Anything he doesn’t take by mouth, he gets thru the tube. This is what we’ll be doing at home, too. (at least this general idea) Then continuous feed overnight.
– dialysis. holding off for now. Yay. first, the NICU is all full, so we couldn’t go down there anyway. second, until we’re absolutely certain there’s no infection, they don’t want to start. and third, he is doing pretty good.
So we’re going to work with his feeds a bit, get things settled down with that, and also watch labs and weight. Maybe we get to go home next week, maybe we start dialysis.