Had a "near save" the other day. 12 year old boy with muscular dystrophy and autism, bedridden. Met at the door by frantic parents and family members- kid was upstairs, back bedroom, in a hospital bed. Walked in the room and saw the kid w/ agonal resps and cyanotic. The family said they were trying to suction mucous from the kid with a (tonsillar cathether) but it was not working. The boy was gagging, biting, and would not tolerate the suctioning. As the kid became more hypoxic, he was fighting them. Not any more-now he was just about ready to code. Put the kid on 02, bagged him a few times, and the kid's color improved almost immediately. He started looking around, acting more normal.
Whew. Vitals OK now, sats at 100%, but still tachy at 160 or so. The cousin asked if she made things worse by giving him mouth to mouth before we got there. I said no- she did the right thing.
The family had a CPAP machine for his use at night, in addition to the suction. I instructed them if he got that bad again and they could not get rid of the mucous plug, call us and then put him on the CPAP machine- it may dislodge the plug- or at least push it down into a bronchus, which although is not good, it's still preferable to apnea.
The kid was lucky- we were literally a couple blocks away, picking up from another call, so we were on scene in about a minute-and he literally didn't have any more time than that. Enroute to the ER, I asked the kid a few questions, and he simply repeated what I had said, looking around. Family stated that was normal mentation for him and clearly relieved.
One for our side...
I am constantly amazed at the lengths people will go to in order to care for a special needs patient at home. His room looked like an ICU, except it was covered in homemade pictures and artwork from his siblings and other family members- very touching. He was impeccably clean, no bed sores, clean gown, clean diaper, hair combed, clean linen- clearly top notch care, and obviously an abundance of love. I told the parents they- and their whole family- were doing a helluva job taking care of their son. They really seemed to appreciate that.