Asleep at 1 am and then awake before 6. An emergency trachy change could have been nasty. Two attempts to put the new one in and then, thankfully, success with the third narrow emergency trachy. It must have been traumatic for both Ryan and the three people involved. Ryan had a temperature of over 38 for the second time this week and had spells of agitation mixed with being relatively quiet whilst I was with him. It is lucky he is in Martin House this week, where skilled medical attention is never more than a few minutes away. Not a good day.