Intensive care

All children will be taken to the Intensive Care unit, also called I.T.U. or I.C.U. after heart surgery. Some will stay there only a few hours, others will be there longer.

Preparation

Usually parents are offered a ‘tour’ of the Intensive Care Unit prior to their child’s operation. Although this can be a traumatic experience, it is very helpful to find out what the various machines do and what all the wires and lines will be doing for your child. Seeing I.T.U. first, helps reduce the shock and emotions when you visit your child for the first time after surgery. If you understand a little of how things work, you will be greatly reassured.

What to expect

Once in Intensive Care, your child will be cared for by a team of very skilled nurses. There will be someone present monitoring your child almost constantly.

Most children will be on a ventilator machine when they first get to I.T.U. This will mean that your child will have a tube coming from his/her mouth which will be attached to the ventilator, it may well be taped to his/her head to prevent it from moving. The ventilator is used to help your child breathe.

Another tube will go through a nostril and into the stomach, this is to drain the stomach and prevent sickness. There will also be a tube coming out from each side of the chest, these drains are used to remove any fluid from the heart or chest cavity. Yet another tube will be used to drain your child’s urine from their bladder until their kidneys are fully functional again.

Thin tubes referred to as ‘lines’ are inserted into veins and an artery, and these are used to administer drugs, give fluids if needed, to take blood samples if required and to keep a constant check on your child’s blood pressure. These will often be located in the child’s groin and also the side of the neck, but the exact location will depend on how easily they can find the veins in your child.

Depending on the type of surgery that your child has had done, he/she will either have a scar down the centre of the chest or under their left arm. Immediately after surgery the scar will be covered with a dressing which will be removed after a few days.

You will see two coiled wires coming from your child’s chest, these are called pacing wires and are routinely used. They are attached directly to the heart, and should a problem develop with the rhythm of your child’s heart, they can be temporarily attached to a pacemaker to help settle the heart back into its normal rhythm.

Your child will be attached to numerous monitors which keep a check on their heart rate, blood pressure and blood oxygen levels, amongst others. All of these are set with minimum and maximum levels, if the readings go outside of these an alarm will sound. This happens quite frequently and is not a cause for worry, the monitoring equipment is there to help the doctors and nurses give your child the best possible care, and give early indication of any changes in your child so that appropriate action can be taken quickly, if needed, to prevent any complications.

Children are generally sedated quite heavily whilst in I.T.U., and most will remember little of their time there.

Visiting the I.T.U.

Parents are usually allowed to visit their child after surgery, as soon as they have been attached to all the equipment needed for their care. Visits can be for as long and as often as you like, although on occasions you may be asked to wait if there is an emergency or the unit is very busy. The I.T.U. staff are there to answer your questions, and will be happy to show you how best to hold your child whilst he/she may be sore. They will encourage you to assist with the care of your child as far as you can.

Although it is very natural to want to sit with your child all the time, this is very tiring mentally, and you should try to ensure that you get proper rest and nourishment so that you are able to cope with your child’s demands once they are no longer sedated – many parents are amazed by the speed of their child’s recovery! Rules relating to visiting by siblings and other family members may vary between units, so it is worth asking the policy on your particular unit.

Leaving I.T.U.

Gradually the various lines and tubes will be removed as your child regains their strength and drugs are reduced. Most children will be off the ventilator within a few days of surgery, and depending on the policy at your unit, your child may then be transferred back to the normal ward, or perhaps to a high dependency ward before they are allowed home. In a few cases, your child may need to be transferred back to your local hospital for a few days until they are fit enough to go home, this may well be done if you live a long way from the cardiac unit.

“On first sight it was difficult to see our baby for all the tubes and wires that were attached to him. The way things had happened we hadn’t had the chance to visit I.T.U. so we’d been told to expect a severe shock when we saw all the equipment, but in fact it wasn’t as bad as we’d imagined. The nurse took time to explain what all the tubes and wires were for, and what the monitors did, and when we understood they were all there to help him, we felt much better. We could still touch him and talk to him, and give him a goodnight kiss!”

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