he hours immediately following open heart surgery are the most critical for a small child. Leonard
faced problems almost immediately after being moved from surgery to the intensive care unit. He developed a fever, and didn't respond
in the way that he should have to the post-operative protocols. His condition was extremely critical.
The team fought the post-op fever the sure way, with ice bags. The multitude of lines coming and
going from the child play a key role in life support, delivering drugs, or monitoring vital statistics.
Leonard's condition did not improve. Doctors found that he needed emergency surgery to re-open his chest,
and they did so right there in his ICU bed. Covering the tiny open chest, they intubated him to moved back upstairs
to surgery for a second operation to discover why he was not bouncing back.
Modern critical care medicine is an amazing science, and the technology that supports critical care is central to its success. Despite
the appearance of a confusing tangle of tubes and wires,
each line, patch, connector, and element plays an important role.
Every line and tube is either delivering drugs, taking fluids into the body, taking
other fluids out of the body, monitoring vital life signs in
real-time and displaying the information on monitors, and providing oxygen and
blood support for breathing and circulation. The keypad by the child's right
knee is a heart pacemaker. The wires leading from the box run
under the chest bandage and into the tissue of the chest, maintaining a steady and controlled
beat for his heart until it has recovered from surgery and can once again do it on
its own.
The symphony of medical science created by all these elements working
together is what makes modern-day pediatric heart surgery on highly complicated heart
birth defects even possible. The surgeon's hands and what happens on the operating table are
only the first step. The ability to deliver the highest-caliber
critical nursing care in the hours and days following surgery is what makes all the difference
between success and failure. For five or six hours in surgery, a child's life is in the hands
of the doctors. But the next two weeks after surgery is when something is most likely to go wrong
if it's going to go wrong. This is just one of the reasons why critical
care nursing is a highly-skilled team exercise, and every member of the team plays a crucial role.