CVICU Day 9

I arrived early at this hospital this morning to make sure that I did not miss rounds. Steele was extubated around 10:30 pm. When the team came by, I immediately addressed the issue about the change in plan from his PICC line to a central line in his upper chest. We had a lengthy discussion of how placement procedures are done in cath lab and how it was better to have better "access" to his heart through the clavicle region of his chest. Using a PICC line near the femoral artery is only short term due to the location and presence of it getting infected since its near his crotch. Ok that makes sense, but why were we not informed by phone? "We did not think it was a medical emergency and it looked good to go ahead and place the central line." I explained that in the past, we were always updated to changes in a medical procedure, and I would appreciate the heads-up from now on."Yes, we understand it was not thoughtful of us to get consent, but this was necessary to move forward". The difference between a PICC line and a "Central Line" is the distance that the tube travels to the heart. Central lines are much closer to the heart and are placed in left subclavian vein (which travels to the heart). Direct access with less travel time and much longer lasting for what they need to do with the tubes. There are two lines that form this central line and end at different points. This is used for medications that don't mix well and could possibly crystallize or clog the tube. It was good to get that discussion off my chest and have our first coming together moment as a new parent with concerns about his care. I realize that they are doing their very best to keep Steele's heath, body, and mind in a good spot. I'm just so tired of the constant rhetoric with "we need access to this..."

Anyway, it felt like we were starting from ground zero finally. So begins the recovery and trajectory of Steele's name on the "list". He was resting well and all the Doc's that I spoke with said "he looks good clinically..."

Happy for now, who knows what tomorrow will bring.