After the Operation: The Intensive Care Unit

After surgery, your child will go to the Pediatric Intensive Care Unit for postoperative care and monitoring.  You will see tubes and lines everywhere.  Here’s what to expect.

A breathing tube (endotracheal or ET tube) will be inserted into your child’s mouth or nose and down into his windpipe and lungs to assist breathing.  While this tube is in place, your child will be unable to talk.  Once the breathing tube is removed, usually within one to two days, you child will receive oxygen from a face mask, nasal canula or oxyhood.  We will encourage him to take deep breaths and to cough to bring up any mucous in the lungs.

A large dressing will cover the chest incision.  Chest tubes, placed during the operation, will drain excess blood and air and will be removed after the drainage subsides, usually within one to three days.  Temporary pacemaker wires also are placed during surgery.  Children sometimes require the temporary help of a pacemaker to regulate their heart rates.

Your child also will have two or three intravenous lines (IVs) and an arterial line to administer fluids and medications and to monitor blood pressure and blood oxygen content.  These lines also allow us to draw blood frequently to monitor drug levels and blood counts.

A urine bag or foley catheter, placed through the urinary opening and into the bladder, enables us to monitor urine output.

Finally, a nasogastric (NG) tube, which is passed through the nose, down the throat and into the stomach, will remain in place for one to two days.  This tube helps prevent an upset stomach by emptying the stomach of air and gastric fluids.

For Your Child

Once again, it’s best if you can prepare your child for this time.  Your time with him may be more restricted in the intensive care unit than in other hospital units.  Keep in mind that most children remember very little about their intensive care stay.

You can expect one nurse each shift to care very closely for your child.  The nurse can help you know what parts of your child’s care, such as bathing or comforting, are safe and helpful for you to do.  Talk reassuringly to your child even while he is still sleepy.  Some children remember hearing people’s voices.

Prepare for this time by making audio recordings of family, friends, pets, music or home events.  You can record these as they happen, such as dinner table conversations, or plan them, such as reading favorite stories.  You also can bring cassettes of your child’s favorite music.

Many children are reassured by seeing photographs of family, friends and pets taped on their bedside.  These items can comfort your child when you can’t be there, such as during doctor’s rounds.

Remember to let your child know:

• When you leave the bedside and when you will return.
• What time of day it is and what day of the week.
• What aspects of care to expect, such as removing the tubes.
• That nurses and doctors are doing everything to help him heal and go home as soon as possible.