As a patient, you are a part of our team. We think it is important for you to know what to expect before, during and after your surgery. We believe that when you know what to expect you will not worry as much, and you will recover better from your surgery.
Monitoring and Life Support Equipment Endotracheal Tube (Breathing Tube)
After you have gone to sleep in the operating room, a breathing tube is put into your mouth and down into your windpipe. The tube is then connected to a ventilator (breathing machine). The ventilator does the work of breathing for you while you are asleep. The endotracheal tube may be in place when you wake up in the CSICU. This is because you may still have anesthesia in your body when you leave the operating room and it will take time (four to eight hours) for it to leave your body. In the meantime you may still need the ventilator to help you breathe.
Once you start to wake up, your nurse will talk to you to keep you awake. The more awake you are, the more breathing you will do on your own. You will not be able to talk while the endotracheal tube is in place but you can make your needs known. You will be able to nod “yes” or “no” when questions are asked and you can write things down on a pad of paper. The endotracheal tube does not hurt and is easy to breathe through. Try not to talk while the endotracheal tube is still in, as this will cause a gagging sensation.
The endotracheal tube is also used to help keep your lungs free of secretions. The nurse will suction mucus from your lungs through the endotracheal tube to help you breath better. The breathing tube will be removed as soon as you are fully awake and able to breathe without the help of the ventilator. After the tube is removed, you may have some soreness in your throat that should go away in a day or two. Once you are off the respirator, we will ask you to take deep breaths and cough to keep your lungs open and free of mucus.
Intravenous (IV)
An intravenous (IV) is a small soft catheter or tube that is placed into a vein in your body. Common sites include the hand, arm and neck. It is used as a direct way to give fluid or medication into the blood stream.
Arterial Line (A line)
An arterial line (A line) is an IV catheter that is placed into the radial artery at the wrist. This is just below your thumb where you can usually feel your pulse. The A line is used to draw blood samples for lab tests and to continuously monitor your blood pressure.
Pulmonary Artery Catheter (PA line)
A pulmonary artery catheter (PA line) is a catheter, similar to an IV, placed into a vein in the neck. The PA line is used to monitor the pressure inside the chambers of your heart.
Cardiac Monitor
A cardiac monitor is a piece of equipment that monitors your heart rate and heart rhythm similar to a continuous EKG.
Blake Drain
A blake drain is soft flexible tube about the same diameter as a pencil that is about 18 inches long. It is inserted through a very small hole in the skin. It is placed into the space around the base of the lung to drain fluid that is produced in the first few days after surgery to prevent a build up of fluid. Several days after surgery, when the drainage slows down, it is slid out through the small hole.
Chest Tube
A chest tube is a plastic tube that is placed into your chest cavity during surgery. The chest tube is then connected to a plastic container or drainage system. The chest tube is used for draining fluids from your chest. It is usually removed the day after surgery or when the drainage becomes very minimal.
Urinary Catheter (Foley Catheter)
A urinary catheter is a small soft tube that is put through the urethra into your bladder. It is then attached to plastic tubing and connected to a drainage bag. The purpose of the catheter is to collect urine. While the catheter is in place you may feel like you have to urinate. The catheter is usually removed the morning after you go to Ellison 8.
Temporary Pacemaker Wires
Temporary pacemaker wires are slender wires that are placed onto the surface of your heart. The ends of the wires come up through the skin and can then be attached to a pacemaker, if needed. The wires are usually removed three days after surgery. As you recover, these IV lines and drainage tubes will be removed. Your doctor will decide when you are ready to be transferred from the CSICU on Blake 8 to the Cardiac Surgery Step Down Unit on Ellison 8.
Your family may visit you in the CSICU. If members of your family cannot visit, we ask that one person be named spokesperson. That person may call the CSICU at 617-724-4410 any time day or night and talk with your nurse. They may then relay information to other family members. The CSICU staff tries to be as flexible as possible with visiting hours. We ask that people try to visit between 10 am and 10 pm, two adults at a time, for 15 to 20 minutes each visit.
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Eighty-eight percent of inpatients would definitely recommend Massachusetts General Hospital to friends and family, compared with a national average of 67 percent.
