PICU- your observations please
- 0Aug 16, '09 by APNgonnabeI would like to start out by saying I know medical advice can not given here....so I would like to hear thoughts, experiences ect....My daughter (perfect to me) most likely has unilateral left corinal craniosynostosis. I do not know the exact name of the surgery that they do to correct it but I went over in fairly great detail with a peds plastics guy who has been doing this for awhile. My wife and I are both RN's (OB & adult ICU). I guess Im looking for other nurses insight as I know we are the ones that usually have the most rational thoughts (at least I'd like to believe).
Please forgive my spelling..it's late
- 1Aug 16, '09 by NotReady4PrimeTime, RN Senior ModeratorLet me see if I understand your post correctly. You're looking for reassurance and not advice. Your daughter has probable unilateral left coronal craniosynostosis. That means that the left coronal suture in her skull has fused prematurely causing a gradually worsening cranial asymmetry and compression of the structures of the left brain and its associated complications. The surgery is called cranial vault remodelling. It's a very long, delicate surgery, as you already know. Our neuro and plastics surgeons do a handful of these every year with minimal complications and extremely good outcomes. The kids generally need PICU monitoring for a day or two to ensure that their facial edema doesn't compromise their airways and to ensure that their neurological function remains normal. I can't remember one that has gone badly. Rest assured, in the right hands your daughter will do very well and no one will ever be able to tell she'd had major surgery as an infant. Please feel free to return and give us an update.
- 0Aug 16, '09 by PICNICRNWe recover these kiddos in the PICU because of the amount of edema they have post op- docs want to make sure they can maintain their airway.I'm sure your docs have prepaired you for what to expect- just be prepaired for a TON of swelling in the face and head- like 2-3 times your child's normal size. It goes away pretty quickly. We used to always keep them intubated overnight just to manage pain and protect that airway. However, I think the "lastest and greatest" reccommends early extubation. So now thay are coming back extubated from the OR. From my experience, this is a pretty painful post op- but if there is one thing we do best in the PICU- its pain management!
From my experience, these kids to very well- like Jan said- I haven't seen any problems in my career with this one either. We usually have them for 1 maybe 2 days, then off to the floor(not sure how long they stay).
I hope hearing from a few of us who take care of these little ones post op helps a little. It is scary to have a child in the hospital for any reason. Please know that I'll be thinking about your little one.... Please let us know how things go!
- 0Aug 17, '09 by PICNICRNQuote from APNgonnabe"what to do" about having the procedure??? Or where/when/who to perform the procedure?? What don't you agree about... if you don't mind me asking??Thus far my wife and I don't seem to agree on what to do...so I still look forward to others...maybe that will help. Thank you.