When you pick up your child from the hospital, after checking out at the inpatient billing office, you will be given.
① a certificate of diagnosis (you need to get it stamped at the hospitalization office).
②Discharge with medication.
③Discharge instructions. At this point, you may be confused about how to take care of your baby, take medication, and many other issues after you go home.
We will answer the questions you may have below.
Vaccination time
1.Inoculation can be given 3 months after surgery.
2.If the baby has never been vaccinated after birth (i.e., has not participated in basic immunization), you should choose the best time for the baby’s physique 3 months after surgery to be vaccinated.
3.If high fever and accelerated respiratory heart rate occur after vaccination, the condition should be closely observed and, if necessary, treated in contact with the local pediatrician of pediatrics.
Wearing a chicken breast control device and using scarring spirit
Most children with congenital heart disease have preoperative augmentation of the precordial region or chicken chest of different severity, and the median incision will make it obvious after surgery; children without preoperative augmentation or chicken chest may also have changes in the median incision after surgery. The sternum can be flattened and fixed with the use of a chicken chest control device to make it grow smoothly and beautifully.
In addition, silicone type scar spirit can be used to soften the scar tissue and make the wound more flat.
Precautions are as follows.
1.Cockle chest treatment instrument starts to be used after discharge from hospital and continues to be worn for 6 months.
2.24 hours continuous use, charging 3 times a day for 30 minutes each time.
3.Please tighten the band when using (to the extent that the skin is not strangled red and can be stretched into the pinky finger for the right elasticity).
4, the summer heat, can cause prickly heat, eczema growth, can be appropriate to reduce the wearing time, wear the prevention and control instrument should be avoided due to prickly heat leading to skin infections eventually lead to sepsis.
5.Sleeping in supine position or side lying position can be adopted to avoid pressure on chest wound.
6.The scar patch can be used repeatedly and cleaned with cool water, not with hot water or sterilized water. It can be used at the same time with the chicken breast control device, and the scar patch is used for 6-9 months. (Please see instructions for details)
Review
Purpose of review: To assess the recovery after surgery, adjust medication, and deal with abnormalities in a timely manner.
1.Explain to the doctor the child’s activity, spirit, appetite, urination and defecation, and whether there is any growth in height and weight.
2.The doctor should pay attention to the lung auscultation, heart rhythm, murmur auscultation, liver size, and the presence of swelling.
3.Electrocardiogram, chest X-ray and ultrasound are selected according to the situation. Long-term diuretics should be noted to review electrolytes.
4.If there is suspicion of atrial defect post-operative releakage, arterial catheter post-operative recanalization, more serious valve closure insufficiency, pericardial effusion, and long-term high fever suspicion of endocarditis, ultrasound can be done to clarify the diagnosis, or you can come to our surgical outpatient clinic for review.
5.Discharge with medicine.
①Generally, children with non-cyanotic precocious heart disease without combined pulmonary hypertension are discharged with medication for 1 month, and the medication can be discontinued after 1 month of review without special conditions.
In the case of non-cyanotic precocious heart disease combined with pulmonary hypertension, it is recommended to take the medication for 3 months, and discharge with the medication for 1 month. 1 month review, the medication can be adjusted according to the situation and continue to use the medication. 3 months, the medication can be reduced or continued according to the situation.
(3) Children with cyanotic precocious heart disease are recommended to take medication for 3 months after surgery and be discharged from the hospital with medication for 1 month. 1 month review, the dosage can be adjusted appropriately according to the situation or continue the medication. 3 months review, the dosage can be reduced or stopped according to the situation.
④Small dose aspirin should be taken for 6 months to lifetime after two-way Gleen, total cavity and body-pulmonary bypass, etc. The medication should not be stopped without authorization.
Diet and activity level
(i) Activity level
Generally, children are not advocated to perform strenuous activities, such as running and jumping, within 6 months after surgery.
1.For those with normal heart function, they can walk in front of the bed and behind the house and get some sunshine.
2.For those with poor heart function (large liver, edema, faster respiratory heart rate, poor mental appetite), the amount of activity should be strictly controlled and more bed rest should be given. 3-6 months after the operation, according to the actual situation of the child, gradually increase the amount of activity according to each person, but still pay attention to control the amount of activity!
3.When there is unexplained panic, shortness of breath, dyspnea, cyanosis, nausea, vomiting, loss of appetite, swelling should be promptly to the hospital to identify the cause to be treated, do not be careless!
(ii) Diet
Should eat less and more meals (3 main meals and 3 supplementary meals).
1. For children <3 months old, feed mother's milk, milk, rice paste, calcium tablets with concentrated liver oil drops, fresh fruit juice, vegetable juice, puree as appropriate. Milk about 6 times a day.
2.3-10 months old infants gradually increase egg yolk (1/4-1/2-1), egg custard, thin porridge, vegetable porridge, minced noodles, minced meat porridge, etc. Supplementary food can be added with fruit juice, cookies, etc., and reduce the number of milk feedings.
3, 10-month-old children should be able to eat noodles, eggs, rotten and crushed chicken, fish, shrimp and vegetables, small pieces of fruit. Pay attention to nutrition to prevent edema or malnutrition caused by low protein.
4.For those with poor heart function, control water intake appropriately, pay attention to urine volume and urine color to avoid increasing the burden on heart and lungs.
5, 3 main meals: breakfast milk, porridge, eggs, etc.; lunch and dinner should be chicken, fish, eggs, shrimp and other high-protein, high-calorie food, fresh vegetables as a supplement, a small amount of rice and noodle food, to seven or eight minutes full.
6.3 times supplementary food time: 9-10 am, 2-3 pm, before going to bed at night. Fruit is the main food, supplemented by good quality cakes, cookies and other foods.
Take medication
When discharged from the hospital, generally according to the child’s condition to bring some cardiac, diuretic, potassium, vasodilators, antibiotics, cough and phlegm, antipyretics, etc.
(i) Antipyretics are generally used for body temperature >38.5℃. Pay attention to increase water intake appropriately after fever and taking antipyretics.
(ii) When the child has phlegm, in addition to taking phlegmolytic drugs, the child should be encouraged to cough and expel phlegm by himself. Parents can pat the back to help the child expel phlegm (especially for small infants, note that the hand is bent and hollow when patting the back, and pat rhythmically from the child’s back from bottom to top, and the hand should have certain strength), and if necessary, separate the index and middle fingers and press the trachea several times to force the child to cough up phlegm, which helps to expel phlegm.
(iii) antibiotic drugs, take 3-5 days after discharge according to the situation, more to take easy to grow thrush (available 2.5% bicarbonate of soda tablets finely mixed paste coated oral cavity) or mouth ulcers (can take vitamin C, B2, local spray watermelon cream).
(iv) Diuretics: dihydrocoumarol, tachyphylaxis, butylamine, aminoglutethimide. Take them as prescribed by the doctor and pay attention to the urine volume.
1. Decide to increase or decrease the amount according to the cardiac function.
2.Do not stop the drug suddenly. When stopping the drug, you can choose to reduce the dose – every other day – every 2nd day – every 3rd day – stop.
3.After stopping diuretics, you should ask your doctor to review regularly to avoid cardiac insufficiency.
4.It can be taken for 3-6 months, or even longer.
5.After taking diuretics for a long time, attention should be paid to regular rechecking of blood electrolytes.
(v) Potassium supplement: 10% potassium citrate (local potassium chloride is also available).
1.Take it as prescribed by the doctor, not more.
2.After taking tachyphylaxis, if there is poor appetite, nausea and vomiting, pay attention to low blood potassium, go to local hospital for emergency blood electrolyte check to correct electrolyte disorder (if necessary, ultrasound to check whether there is pericardial effusion).
3, vasoactive drugs: Kepone (Captopril). Please pay attention to the presence of dizziness and hypotension, and reduce or stop the dosage if necessary.
Other precautions
1.Complex malformations such as right ventricular double outlet, transposition of the great arteries, single ventricle, etc. should be reviewed once a month in the early postoperative period, and the review time can be extended appropriately with postoperative recovery.
2.Taking diuretic drugs, the child may have dry stools or even abdominal distension, and the number of bowel movements may decrease. At this time, you should encourage the child to develop the habit of daily bowel movements, eat more vegetables and fruits, drink honey water, and take drugs to laxative when necessary.
3.After the child is discharged from the hospital and sees his parents, his emotions change a lot, and the environment changes, some children appear to have low fever, cry, and do not sleep, etc. Generally, they get better on their own after 2 to 5 days. You should soothe your child in time to facilitate recovery.
4, review: routine review or new problems after discharge, please go to the surgical outpatient registration consultation or negative difference if you have returned to the field can write a letter or big phone, we will answer your questions.