15 month old

[jeepmedic]

Had a call this AM to a 15 month old having trouble breathing.

ATF a 15 month old boy in mothers arms having periods of apnea. Mother not displaying the normal panic look when baby stops breathing just pats child on back and says " come on son breath." So I am thinking this is normal for this child. Ask for PMHx and mother states child has Guacher Disease. I am like "what the F*** is that" She states that child does not make enzymes like a normal child. Also has a weak Trach. so he can not cough up flem very good. I called the incomming unit and told them to bring in the suction. The child has rales in uper airway. So I am going to suction and everything will be fine nice easy ride to the ED. WRONG. Mother tells me that every time someone tries to suction Jr. he codes. So what is a idiot to do? :wacko:

 

[Ridryder911]

Gaucher (pronounced Go-Shay) is a genetic defect usually affecting the Russian/Jewish/Swede descendents and have a enzyme defect. Usually they do not go past 2 years of age. Usually the sign & symptoms are abnormal bone growth, anemia, and hepatic and spleen disorders.

I presume what the mother was describing "coding" after suctioning is that it vagals and very sensitive to hypoxia. I personally would attempt to preoxygenate as much as possible, even assist with BVM and monitor for decreased HR, and any de-sats to occur. Quick suction and low aggressiveness as possible... but, one has to obtain and maintain an airway .. but, if they are moving air already.. I am not going to "break it" either..


A judgement call...

R/r 91

 

[jeepmedic]

Gaucher (pronounced Go-Shay) is a genetic defect usually affecting the Russian/Jewish/Swede descendents and have a enzyme defect. Usually they do not go past 2 years of age. Usually the sign & symptoms are abnormal bone growth, anemia, and hepatic and spleen disorders.

I presume what the mother was describing "coding" after suctioning is that it vagals and very sensitive to hypoxia. I personally would attempt to preoxygenate as much as possible, even assist with BVM and monitor for decreased HR, and any de-sats to occur. Quick suction and low aggressiveness as possible... but, one has to obtain and maintain an airway .. but, if they are moving air already.. I am not going to "break it" either..


A judgement call...

R/r 91

This is what I did. I transported with blow by O2. Mother holding the baby.

Every time I tried anything with the child he would start crying then have a period of apnea. So it was O2 and rapid Transport with Airway kit beside me. O2 sats. 88% at house. During transport O2 sats now at 100% with the blow by and Idiot (me) leaving Jr. alone. Tried to Do no harm but be prepaired to act if Jr. went into Respirtory Arrest. At ED child looked better and mother stated that child was somewhat better.