CHEO

We arrived at CHEO around one o'clock and went straight to the emergency department.

We probably waited about twenty minutes in triage for our initial assessment.  Not long but it felt like a lifetime... Caelan, feeling unwell, wanted me to hold him, in addition to his suction machine, emergency kit and the back pack I had filled with clothes, food and entertainment necessary for a trip to the emergency room.  Felt a bit like a pack mule.

Immediately upon that initial assessment Caelan starts to get agitated and upset.  He's been here before he knows what's happening.  He's nobody's fool.  Well his O2 sats drop into the low 80s so off to resuscitation we go.  Once calmed down his sats are a bit more acceptable in the mid to low 90s.  I'm referring to his levels of oxygen saturation, we would love 100, we accept that his norm is more like 97-98.  Under 91 is unacceptable and you're put on oxygen.

Now forgive me because I can't remember the order of things, but going for a chest X-ray to rule out pneumonia was pretty high on the priority list.  He also received a ventolin treatment with atrovent added to try and open up his lungs to allow him to breathe easier. Unfortunately this treatment, often used with asthma patients, had little to no effect.   They also ran a swab test on his secretions to check for bacterial infections or viruses there.

The X-rays came back and although there was some fluid in the lungs it was really minimal and no sign of pneumonia.  So happy to hear this as it was a major concern.  However the swab came back positive for RSV.  Ugh.  I knew it wasn't good.  Heck he'd had shots every month over the cold and flu season for two years to protect him against RSV when he was an infant...

So what is RSV I ask... Well basically a really bad cold.  Respiratory syncytial virus.  Bottom line is that it's a virus so no antibiotics, only supportive treatments to help you breath.  Oxygen, in combination with ventolin and or epinephrine nebulizers.  No guarantee that any of these supportive treatments will help though.  Obviously the oxygen does, but I have to tell you even on oxygen, Caelan is still having great difficulty breathing.

Shortly after getting the results we were moved from the resuscitation bay to an emergency "room"... Here Caelan got a dose of prednisone and he was given three ventolin treatments back to back.  While this did increase his secretions and possibly clear him up the effects were very short lived and did nothing for his shallow rapid breathing and nasal flaring that had prompted me to be there in the first place.   However they continued to give ventolin treatments every hour for the rest of the night.  This was to treat a wheeze they could hear in his lungs.  (I was asked repeatedly if he had asthma.)

Since Caelan had required oxygen to keep his O2 sats in the acceptable range our entire visit, there was little chance of us getting home so it came as no surprise when we were told he was being admitted.  The question was where?  Was he going to the floor or the ICU?