What Parents Need to Know
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.
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. We may take blood samples from them as well.
Feeding: A tube will be placed through your child’s nose into their stomach, and we use this tube to feed the child. In addition, we are able to drain off excess fluid and air and administer medicines through the tube.
Sedation: One of our most important priorities is to ensure that your child does not experience any pain or discomfort while on the PCICU. We will therefore administer regular and/or continuous doses of sedation and pain relief to make sure each child is comfortable.
Catheters: This is a tube sometimes placed into the bladder to measure urine output.
Help with Breathing: For many of our young patients who need help with breathing after heart surgery we connect a breathing machine, or ventilator. An 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.
The U.S. News & World Report 2013-2014 “Best Children’s Hospital” edition ranks Mount Sinai in seven specialities.