Fickle Chest Tube

Eric had another "episode" around noon today. Out of the blue, he became very short of breath, his SpO2 decreased, and his respiratory rate, heart rate, and blood pressure rose. It all started with physical therapy, all that moving around, sitting on the edge of the bed. Well, we've seen this before and knew exactly what was happening. We looked at that left chest tube water seal drain apparatus and sure enough, it wasn't bubbling, meaning it wasn't draining the air from the space just outside his lung, and that air was building up (called a pneumothorax), pressing in on his lung, and making it difficult for Eric to breath. The nurse called the doctor, who ordered a "stat" chest x-ray. X-ray came about 45 minutes later, and then we had to wait for a doctor to look at the x-ray. Meanwhile, Eric was miserable. We know that the left chest tube is positional so, taking matters into my own hands, I said to the nurse, "Watch for bubbles," and I gently pushed his chest tube sideways slightly toward his navel. "I see bubbles," the nurse said. So I just held it there. Immediately, we watched his SpO2 creep back up, and his HR, RR, and BP slip back down. If I released the pressure and it rotated back, the bubbling stopped again. "I'll hold it all day if I have to," I said. And I did for quite awhile, a look of immense gratitude on Eric's face. But finally, we just taped it real good in that same position. Eventually, a resident looked at the x-ray, confirmed that he had a growing left lower lobe pneumo, but seemed to be satisfied that we'd resolved the problem. Eric took a nice long nap after that. Until PT came back and woke him up to exercise again.

Tomorrow's the big day . . . Eric gets his tracheostomy. No more endotracheal tube hanging out of his mouth.