In Practice: Finding Our Way

作者: Kathryn Weise

DOI: 10.2307/3528683

关键词:

摘要: The day Amanda was transferred to our Pediatric Intensive Care Unit (PICU), we communicated anxiety, born of experience, by sidelong glances and terse descriptions her array cardiac anomalies. "Like Jeremy's, but worse. No main pulmonary trunk echocardiogram, they couldn't find good branch arteries. She'll need catheterization this afternoon see if can anything big enough accept a shunt." To the pediatric intensivists, bedside physicians ICU, brought up memories several infants referred over last few years. In more successful cases, surgery careful intensive care had allowed us send home children who were still blue, alive active. At other end spectrum handful undergone one or attempts blood lungs support life, died after days--or many long months. Cardiology surgical groups accepted into unit, went work supporting during evaluation. She mechanically ventilated control breathing, crucial fine tune balance flow between body, she received medications constant infusion. We hoped that specialists involved in would eventually be able home. also parents been hold awake before transfer, since it days do things normal baby do--take deep breath, cry out loud, wet diaper could change. wasn't lucky, with heart like hers, down road from centers country give chance at living for than days. Although only twenty years old without financial means, part large close-knit family strong faith community. Since parents' first baby, devote all their attention her. Still, having face kind challenge as hopeful new is almost unimaginable. Being swept complex sophisticated medical system time needed save newborns life best luck--or maybe not. sailed through hitch, consented placement shunt major artery tiny vessel later. After surgery, remained very blue because arteries so small severely limited amount oxygen bloodstream pick up. team taking included surgeons, cardiologists, nephrologists, infectious disease specialists, nurse practitioners, clinical critical nurses, respiratory therapists, physical occupational hospital chaplains, social workers. Others contributed care, including such stalwarts unit nursing assistants ward secretaries, supported staff alike. Over next three months, came know talk became well versed lingo details what some call "chronic care." They learned which alarms worrisome listened minutes. PICU on first-name basis, met residents rotated through, where coffee pot was, settled routine. Certain optimistic others, group seen whose grow time, given chance. But Amanda's did not improve. While developed personality wrapped around little finger, dependent ventilator IV feeding steadily bluer. Any exertion caused get suddenly Owing breathing tube, hadn't heard born, even when made called "cry face. …

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