As we are heading into the NICU to wash or our hands before going back to room 1, one of RT’s favorite respiratory therapists tells us it’s CPAP day!

Weight on the board is 1938! Kid just keeps on growing! I wonder how many days till he will be 5lbs!

Woah RT will be mooving to CPAP! The machine is set up  sitting next to his incubator ready to be swapped over!

Good morning RT!

Nurse today is one of his primaries!

We start cares,  temp is fine,  diaper is just pee.

Two respiratory therapists come to swap RT over to CPAP. They put him on the neopuff while disconnecting the NIV NAVA and moving it out of the way. CPAP has a more strappy hat,  looks more like an old football helmet. They lift his head and slide the hat under,  strap it on.

Neopuff pressure set to 8. Nasal prongs this first time, they are a softer silicon than the ones niv nava had. He actually doesn’t seem to mind the nasal prongs this time!  As soon as they are done he yawns!  What a big boy,  showing off.  He didn’t get upset at all this care.

We will leave his EDI catheter in for now incase we have to switch back.

CPAP (CPAP, or continuous positive airway pressure) is a machine that just provides a constant pressure,  and a way to adjust oxygen percent. It doesnt monitor his brain signals to his diaphragm like niv nava or give assistance with his breaths with bursts of pressure, it doesn’t detect him having apnea, or alarm for taking too small of breaths.

It is a much simpler machine, he has to breathe all by himself other than the constant pressure helping hold his airway open. Quiter, with less alarms!

If he isn’t breathing enough it will be seen on his monitor along side his heart rate and spo2. If his respiration rate goes to zero it will alarm. And his spo2 will go down and alarm.

You’ve got this buddy!

We settle out to 27% oxygen,  pretty awesome!  Only 6 percent higher than room air! We give him some milk swabs and binky for being such a good boy!

I think he likes this ventilator more already!

What a strong boy! Keep the progression going RT!

One of RT’s other primaries comes up to visit and check on him!  She sees he is on CPAP and is extatic! Everyone is so proud of RT!

He has many fans! One of the nurses mentions she fell for him because he has developed such a personality so early on!

All the energy that surrounds him, the faith everyone has in him, and the support he gets is paying off!

Eventally we do lunch,  then ofcourse back to the NICU!

He is still doing good, same percent oxygen.

With CPAP, there is less information to be watched on how he is breathing. With niv nava there was the pressure, the resorption rate,  the volume, his brain waves and so much more.

This is just pressure.

1400 cares,  temp is good,  just pee, remove EDI catheter and OG tube. Nurse replaces OG tube with a fresh one.  Old one is nasty.

No more EDI catheter!  Only one small OG tube going into his tummy now! Everything else is just electrode sensors and his spo2 sensor!

Skin to skin with mom!  I take some photos!

1700 comes quick.

Cares,  temp is good,  just pee. Swap to nasal mask.  He is relaxed and still has not gotten angry at all today,  he even had some smiles when he was on mom, and during milk swab and binky time too!

Hang out for a little, then dinner.  We have a celebration desert!

Back up to NICU nurse tonight is same one as last night!

One of RT’s favorite night respiratory therapists has him tonight too!

Temp, just pee. Hopefully he poops soon,  it’s been over 24 hours now.

Respiratory therapist swaps him to nasal prongs,  he has a brief angry face but calms in a second or two.

Good boy, calm boy, happy boy!

He peed some more,  I replace it with a clean diaper.

We position him and snugle him up.

An outstanding day! Keep it up!