Kravis Children's Hospital Benkov
Pediatric Cardiology

Overview

Through state-of-the-art diagnosis and comprehensive, family-centered treatment, Mount Sinai has achieved extraordinary success in diagnosing and treating the most difficult and complex cardiac conditions in fetuses, children, and young adults.

We offer a complete range of diagnostic services, including pediatric and fetal echocardiography, exercise testing, Holter monitoring, cardiac MRI, electrophysiology, and cardiovascular genetics. With the Division of Pediatric Cardiology working in concert with the Department of Cardiothoracic Surgery, our experts provide the full spectrum of surgical and interventional catheterization treatments for congenital and acquired pediatric heart diseases.

Working closely with the patient’s referring physician, our interdisciplinary team evaluates each patient’s condition and circumstances, and develops a comprehensive treatment plan. Our success in treating patients with a broad range of heart conditions is built on our exceptional team, which is comprised of:

  • Pediatric Cardiologists
  • Pediatric Cardiothoracic Surgeons
  • Pediatric Cardiac Anesthesiologists
  • Pediatric Physician's Assistants
  • Advanced Practice Nurses
  • Pediatric Cardiac Sonographers
  • Social Workers
  • Child Life Specialists

 

The Pediatric Cardiac/Cardiothoracis Intensive Care Unit (PCICU)

The Mount Sinai pediatric facilities include a six-bed pediatric cardiac/cardiothoracic ICU (PCICU), an eight-bed pediatric ICU, a 38-bed neonatal ICU, 75 pediatric inpatient beds, and a pediatric emergency room. The Pediatric Cardiac Intensive Care Unit (PCICU) is located on the 6th floor of the Guggenheim Pavillion, close to the cardiac ORs and catheterization laboratory. Outpatient visits take place in the Annenberg Building, 3rd floor, Suite 3-50.

Introduction to the PCICU

The configuration of the PCICU improves the flow and care of patients within the hospital and allows patients and families to be on the normal ward environment as quickly as possible.

The PCICU is for all patients with congenital heart disease who need intensive care for conditions involving the heart, lungs or airways. It is also responsible for the care of children on extra-corporeal membrane oxygenation (ECMO) and is staffed 24 hours a day by specially trained doctors, physician assistants, and nurses.

The team that will care for your child will be multidisciplinary – involving intensive care doctors and nurses, cardiologists, cardiac surgeons, ventilator technicians, physiotherapists, dieticians, pharmacists, chaplains, volunteers and housekeepers. The person who coordinates your child’s care while on CCCU is the Intensive Care Attending.

Admission to PCICU

When your child is admitted to PCICU they will be attached to monitors, drips, and tubes to feed them and give medication. This takes about 45 minutes, after which they will be ready for you to visit.

Visiting the PCICU

Your child still needs you, even though they are being cared for by all of these people! It’s useful if you tell us about your child’s personality and their likes and dislikes. The unit encourages parents to visit their children and stay as long as possible.

The Routine on the PCICU

Having a child on PCICU is a frightening and disorientating experience since everything is unfamiliar. Please remember that everybody on the unit is here to help you and your child, and you should feel free to ask any questions about anything you don’t understand or are uncomfortable with. Here are some of the things you may see on PCICU and that are used in your child’s care.

  • Monitors: Every child on PCICU is connected to a monitor. The job of the monitor is to provide at-a-glance information about the patient’s heart rate, blood pressure, temperature and the amount of oxygen in the blood.The heart rate is measured using small sticky pads (ECG electrodes) attached across the chest.Blood pressure is measured either using a blood pressure cuff (like in your doctor’s office) or by a small tube placed into an artery (usually either in the wrist, groin or upper arm). These arterial lines also allow us to take blood samples on the unit without having to constantly use different needles. Temperature is measured using a temperature probe placed either at the back of your child’s nose or in the bladder .
  • Cannulae and Central Lines: These are tubes that give fluids and drugs that run into your child’s veins. Blood samples can also be taken from them also.
  • Feeding: A tube will be placed through your child’s nose into their stomach. This is a nasogastric tube and is used to feed the child. In addition, access fluid and air can be drained off via the tube and medicines can also be given through it.
  • Sedation: One of our most important priorities is that your child does not suffer any pain or discomfort whilst on PCICU. We will therefore give your child regular and/or continuous doses of sedation and pain relief to make sure they are comfortable.
  • Catheters: This is a tube sometimes placed into the bladder to measure urine output.
  • Help with Breathing: Most children need help with breathing after heart surgery. They will be connected to a breathing machine, or ventilator, to help them breath. To do this, a tube called an endotracheal (ET) tube is placed from the mouth into the windpipe (trachea). To make the child comfortable anaesthetic is used.
    When a child is connected to a breathing machine suction is performed to remove phlegm and secretions that the child is unable to clear by itself because of the ET tube. A very thin tube, called a suction catheter, is inserted down the ET tube and the secretions are sucked out.
    Children who need help with breathing are at very slightly increased risk of chest infections. If this happens the treatment is using antibiotics and physiotherapy.
  • Chest Drains: Chest drains are used after heart surgery to drain blood and air from the chest cavity, allowing the lungs to expand properly. They are usually put in by the surgeons before the child comes back to PCICU. These and other drains may also be put in on PCICU.
  • Pacing Wires: Pacing wires are blue wires that are left in by the surgeon after heart surgery. They allow the medical team to control the heartbeat with a pacemaker if needed.

Procedures on the PCICU


As described above, various tubes and lines will be placed for a variety of medical reasons. Sometimes these tubes will fall out, be displaced or need changing for another reason.

Although the staff on the unit will try and discuss this with you, as with everything, because the tubes are needed for constant monitoring they may have to be changed without prior discussion.

In emergency situations procedures to save life will always be carried out in accordance with professional guidelines unless a specific discussion has been had before hand.

Caring for Parents

It is important that parents look after themselves. Your child needs you to be in good condition. You should try and get away from the unit sometimes to go for a walk or get some rest. Eating well is important, as is drinking enough – especially if you are a breast feeding mother. The lounge area for parents is located close to the PCICU.

 

Contact Information

Talk to us: (212) 241-8662

Location:

Division of Pediatric Cardiology, The Mount Sinai Medical Center, One Gustave L. Levy Place, Box 1201, New York, NY 10029

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