Care(1) Knowledge of the heart lesions and operationChildren are dependent of their parents. To care for a child with congenital heart disease before or after cardiac operation it is important for parents to know the heart lesion; how it will affect the child and how the child will respond if the condition changes. Parents need not to be an expert on the child's heart lesion but to be confident on the day-to-day assessment of the child's symptoms. Nurses and doctors will discuss with you about the results of the operation, possible complications during the recovery phase, medications that are required, and warning signs that indicates something wrong. The cardiac operation that is performed may be just one of the stages towards total correction. Parents should have a clear idea of what is going on. The child may be seen by other doctors for other illnesses and it is important that parents can communicate with them about the heart lesion and the latest development. (2) Follow-up visitsClose and regular follow-up is necessary after cardiac operation to detect any complication. Some complications are fatal if not treated promptly, e.g. pericardial effusion which means accumulation of fluid within the 'sac' surrounding the heart. During the visits medications may be adjusted according to findings of physical examination, cardiac ultrasound and chest X-ray. If the child's condition is stable the follow-up can be spaced out gradually. (3) Observation at homeThe child's condition may change after discharge home. Parents are advised to observe the followings: general state, overall activity, respiration, colour, temperature, puffiness of face, feeding difficulty, vomiting and abdominal discomfort. Inform our staff at the Day Care centre or the Children's ward by phone if you think the child is ill or if you worry about your child's condition. An early assessment may be required to clarify the observation. However if the child is obviously ill and immediate treatment may be needed then you should bring your child to the nearest Accident & Emergency Department without delay. Arrangement to see our specialist again will be made by the concerned paediatricians. (4) MedicationsDrugs should be taken according to the instruction from the pharmacy. The medications should not be withheld without the advice from doctors or nurses. Our pharmacist or nursing staff will explain to you the action and possible side effects of each medication. If you have any question about your child's medications you should clarify with our staff before going home. (5) Chest PhysiotherapyIt is not uncommon to have retention of sputum and secretion in the lungs after cardiac operation. This may result in chest infection. All children will have post-operative chest physiotherapy while staying in hospital. Parents are advised to learn simple skills such as chest percussion and breathing exercise from our physiotherapists so that the therapy can be continued at home if necessary. (6) Wound Care The surgical wound usually heals in 10-14 days. The importance of personal hygiene cannot be overemphasized. Redness, swelling of the wound may indicate infection and should be reported immediately. If the wound does not gap the child can have a bath every day at home. After a bath the wound should be kept dry and protected with dressings.
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