Friday, October 8, 2010

Learning about PICC's....

The idea of a PICC line really scared me when they decided to put one in Broderyck's right arm for long term IV's. It also really scared me when they told me that I would be the one administering the antibiotics after we go home. But after the nurses have given me paperwork and let me practice  under their supervision. We will also be assigned a home health program to come and do dressing changes and provide the antibiotics, saline flushes and heparin flushes. It will stay in for at least 6 weeks.

Getting ready to put in the PICC

After the PICC was put in, under an awesome dinosaur wrap
A PICC line is, by definition and per its acronym, a peripherally inserted central catheter. It is long, slender, small, flexible tube that is inserted into a peripheral vein, typically in the upper arm, and advanced until the catheter tip terminates in a large vein in the chest near the heart to obtain intravenous access. It is similar to other central lines as it terminates into a large vessel near the heart. However, unlike other central lines, its point of entry is from the periphery of the body � the extremities. And typically the upper arm is the area of choice.
A PICC line provides the best of both worlds concerning venous access. Similar to a standard IV, it is inserted in the arm, and usually in the upper arm under the benefits of ultrasound visualization. Also, PICCs differ from peripheral IV access but similar to central lines in that a PICCs termination point is centrally located in the body allowing for treatment that could not be obtained from standard periphery IV access. In addition, PICC insertions are less invasive, have decreased complication risk associated with them, and remain for a much longer duration than other central or periphery access devices.
Using ultrasound technology to visualize a deep, large vessel in the upper arm, the PICC catheter is inserted by a specially trained and certified PICC nurse specialist. Post insertion at the bedside, a chest x-ray is obtained to confirm ideal placement. The entire procedure is done in the patient�s room decreasing discomfort, transportation, and loss of nursing care.

Monday, October 4, 2010

Prepare for the eventual let down....

On Monday the 27th I couldn't have been happier they ran antibiotics, did blood tests and told us that everything was trending in the right direction. His wound started to look a lot better and I thought we were in the clear. We went to clinic on Wednesday and that blood test showed that things were still going in the direction that we wanted them too and the wound team looked under his bandage and said that it looked really good. They said that I wouldn't need to change the bandage until we came in the following Wednesday but gave me an extra bandage, just in case. The cardiologist told us we could just do oxygen at night and that he could stop taking lasix. 

This is the point where I get my hopes up and start to think that everything is going the way it's supposed to.

Then of course on Thursday Broderyck started acting really uncomfortable again, crying and not wanting to be put down. I figured he just was still sore from surgery and didn't mind holding him almost constantly. Saturday his bandage was about 3/4 saturated and I decided to change it, then that night he started breathing heavier and running a fever. Sunday morning his second bandage was completely saturated to the point that it was falling off.
I called the hospital and they said that since it was Sunday that we'd need to come tot he Emergency Room but the Cardiothoracic Nurse Practitioner would meet us there. We switched the bandage once more and I packed a bag and we headed on our way. When we got to the hospital the Nurse Practitioner looked at his wound and knew it was bad, and the admission process started again...

for the 3rd time

They starting running antibiotics again and determined they were going to do exploritory surgery to see how deep the infection is. They switched the time a couple times today and had to run some IV fluids and do a blood transfusion before they could take him back to the OR.

They took him back around 6:30pm and it's now 10:15. They had a hard time finding veins for an IV because he's been so picked on by the lab that he's running out of good veins. Last I heard was that it was a really deep infection and that they had to take the wires out of this chest to be able to clean out his chest better. 
After this surgery he will go back to the CICU and be back on a ventilator. I really hoped that it was going to be a simple fix and I am praying that when they fix this that Broderyck will be able to go home and be a normal baby...

he is supposed to be learning to smile and roll over...not spending 1/3 of his life in the hospital.

The Nurse Practitioner just came and gave us an update. She said that it just didn't look as healthy as it should. They cleaned his chest out with antibacterial fluid and will put a wound vac on for a couple days and put a chest tube back in.

Please let this be it...
The OR nurse is supposed to call if the surgeon can't call us before 11:30.