Good Alarms

We've spent a lot of time in the NICU at this point, and heard a lot of alarms. Alarms from Andrew, alarms from other babies, even the phone and intercom sound like alarms. For each baby, there are also several triggers for alarms....an IV infusion that's finished, a pulse or BP that's too high, an oxygen saturation that's too low, a ventilator that's lost pressure, etc. It's important to learn to differentiate between Andrew's alarms and those of other babies (so we don't worry ourselves), and to differentiate between unimportant alarms (empty IV) and important ones (desaturation). There are some alarms that will make ten nurses, doctors, and respiratory therapists come running (literally). There are others that can be completely ignored. Yet until tonight, we had never run into a happy alarm.

We stopped by for a visit after dinner tonight, and he was still doing pretty well. They had weaned his vent down a bit but brought his oxygen up a bit...basically a wash. However, they had changed the alarm settings so that his oxygen saturation needed to be between 87 and 95. It's been hovering in the low 90's during the last few days, but should be up in the high 90's. If the alarm goes off on the low end, they know they need to turn up the oxygen in the vent. If it's on the high end, they know they can probably wean him a bit. While we were there and interacting with him, his alarm was consistently going off for being too high. His saturation averaged around 97, with short periods of a perfect 100. They didn't want to wean based on those numbers, because they assumed that he was doing well because of our interaction...basically, the two of us being there was making him do a little better. But, they didn't want to reset the alarm boundaries, because the parameters were going to be the same all night. So, we had to listen to his alarm go off for quite a while (turned off in 30-second increments), telling us how great his oxygen saturation was. Definitely a good problem to have.