How are you positioning the NC? Dont tighten it under her chin like an adult would wear it, instead put the prongs in the nose, and adhere the cannula up by her eyes - not level with her nostrils, keeping it up higher will hopefully reduce them coming out, then tighten the cannula up by the top of her head.Tegaderm is pretty weak, I place douderm down on the skin, place the cannula on top, then secure with 3M multipore tape. Taping the cannula to the douderm not to the skin, that way if it is tore off, the skin isnt being torn. Hope this helps.
Any respiratory therapists or pulmonologists on here? I feel like I'm getting no support in weaning my 4 month daughter off her home oxygen and my anxiety is through the roof.4 month female15.5 lbsWhiteLow oxygen saturations is the main concernFlovent, bactrim, iron, vitamin d, recently discontinued diuril.My 4 month corrected has been off daytime for months, always 97 and above, usually 99 or 100.Nightime weaning has been more difficult because of her periodic breathing. Its usually the most extreme when she first falls asleep. She will go up and down from 97 to 89/88/87/86 sometimes low 80's every 10 seconds or so. Down 5 seconds, up 5 seconds. This happens over and over again for about an hour, then she comes out of it and sits at 97/95. Then she goes back into it, usually not dipping as low as the first cycle.The first time they tried to trial her off nighttime they told me to "watch her" the night before her appointment. I tried to get more info. When do I put the oxygen back on? What is concerning? "Just watch her". So I stayed up as late as I could and tried to peek intermittently. Lowest I saw was 89. This didn't seem like the most accurate sleep study but whatever. She had been tearing out her oxygen every single night at this point for weeks. After me relaying what sats I saw, they decided to wean the diurul first, then check back in in Feb.I reached out this past week because its been impossible to keep her oxygen in. I'm using the works, the strongest adhesives, using mittens, socks, swaddles, and she still manages to get it out. She's also started trying to eat her tegaderm and I am certain she ate some at least one night. And a really problematic rash has been developing on her cheeks from the duoderm. I decided to leave her oxygen out since last week after the tape eating incident and to give her cheeks a chance to heal. I let her NP and NEO follow up know and they are in agreement that we should just leave it out indefinitely and "see what she does". But what does that mean exactly! Shes definitely going lower than usual the past couple of days, as low as 83 so far.TLDR: WHEN DO I PUT THE OXYGEN BACK ON WHAT IS SAFE/NOT SAFE. I have asked her NP time and time over what her parameters are and she never gives me a straight answer. I understand that dips to 80s are fine. But how many? She cycles like this for at least an hour every night, probably a total of 2 or 3 hours. Are these dips cumulatively an issue? We've never gotten an alarm when her oxygen is out (alarms at below 90 for longer than 10 seconds). Should I just based my concern off of that? I have to go back to work in a couple of weeks and will no longer have time to stay up late watching her monitor and watching her naps.