When In Doubt… Bag ( Ambu bag)

Before we left the NICU I have had many discussions and hands-on experience with the respiratory therapists there. While all of them have different ways on how they do certain things, there was one constant thing that they told me to remember. When in doubt… bag! When I say “bag” I mean ambu bagging. They educated me on things to watch out for like his oxygen saturation, the way Isaac was breathing, listening with the stethoscope for his breath sounds, his breath rate,etc. One of his primary respiratory therapists made me practice bagging Isaac so that I could tell how it feels like.  Before we got home I was also briefed on the different settings and numbers on the vent as well as troubleshoot a little bit.

When a health professional tells you all the things you need to remember you nod your head and say “oh, okay” but after a few other tutorials you have had about all the machines your child is going home with it is hard to remember anything! I tried to write as much details as I can but for some things writing is not enough.

I had 2 instances when we had to bag Isaac. The first one was the fact that his oxygen saturation was coming down. He was starting to turn a little dusky. The nurse and I thought that it was the pulse oximeter probe that was on his toe since he moves a lot. But the vent was also showing “low pressure” on the screen. My husbsnd walked in the room, took one look at Isaac and told us to get the ambu bag out and start bagging. We bagged for a couple of minutes until we figured out which connection on the vent was loose. When we found it and his saturation was where it should be, we stopped.  The second situation was he was also showing signs of desaturation (dusky lips) but the vent was not alarming. When the nurse checked the oxygen tubing on the side of the vent she saw that it had come loose! He was not getting oxygen at all! We had already started bagging him before we discovered this. With both situations I realized that as human beings there is something in us that makes us want to fix things when they are not working. We were spending precious time trying to figure out what was going on instead of bagging immediately and then trying to figure out what the problem was. Everyone is vulnerable to this. As a parent, we are of course susceptible to it but even home health nurses who have not had the experience to go through a critical situation like that are vulnerable. They are trained to respond accordingly to these kinds of situations but they can still fall short and do not respond like they should.

Isaac’s main problem is respiratory in nature, so if anything fails,it will be something respiratory. He goes through situations now when we have to bag him for various reasons. But now I consider the ambu bag a necessary accesory. I am no longer afraid to use it because I know it is what I have to do to save the life of my son. Checking the bag as well as the oxygen tubing and oxygen tank are part of my nurses routine as well as mine. We leave the tank unlocked but the oxygen gauge is on zero. This is so that in an emergency situation we can just pick up the bag and turn the dial on the gauge all the way up and start bagging! Nobody dies of too much oxygen!

As I am writing this, it just occurred to me that I do not have a back up ambu bag. There was an instance when we had to bag Isaac and the bag had a leak in it. It was fortunate that I had another one to use.  I need to touch base with my DME company soon. The ambu bag is your back up in case the vent fails. I am the type of person that wants a back up to the back up! God gave me Isaac to take care of and I want to make sure I do that job well.