Almost six years ago I moved from a general PICU to a PCICU (well mostly: about 2/3 of our patients are cardiac). One thing I did to prepare was to read the report on the Manitoba Pediatric Cardiac Inquest (http://www.pediatriccardiacinquest.mb.ca
). It didn't start out as prep but turned into it when I realized how much information there was within it about cardiac defects, their repairs and what can go wrong. For the unaware, in 1994 the Winnipeg Children's Hospital (where I used to work, but 3 years after these events) had a new and rather green pediatric cardiothoracic surgeon. 12 infants and children died during or following surgery and the situation became the basis for the longest medical inquest in Canadian history. The report makes for frightening but enlightening reading. Of course, techniques have changed a lot since 1994 and so has the nursing care. Cincinnati Children's Hospital (www.cincinnatichildrens.org
) has an excellent web site that has animated images of different defects and their repairs. You might also want to review the care and feeding of the intracardiac line, mediastinal chest tube, multiple lumen central line and open sternum. Look at a good drug resource on infusions for information on epinephrine, norepinephrine, sodium nitroprusside, amiodarone, milrinone, nitroglycerine, alprostadil and magnesium. Know the onset of effect of captopril. Brush up on your PALS, especially rhythms. And be prepared for some rocky days ahead, with a new program there will always be a hill to climb before things become comfortable. Good luck!