Your Stay in the Intensive Care Unit at Covenant Health

You will be on the breathing machine (ventilator) until you are awake enough to breathe effectively on your own. 

The breathing machine is attached to a tube in your mouth that goes down your windpipe to help you breathe. This tube interferes with the vocal cord function, and you will not be able to talk while this tube is in place. Occasionally this tube also makes you feel like you are going to cough, which can be a bit uncomfortable, but typically passes quickly. 

When you are stable and the nurse and respiratory therapist feels you are ready, tests will be done on the breathing machine to determine if you are ready to come off of the ventilator. 

During these assessments, you’ll be asked to take a deep breath, and blow air out, all while still having the tube in place. This is to check if you are ready to breathe on your own.  

The nurse and/or respiratory therapist will also encourage you to cough and take deep breaths to ensure you are getting rid of any extra mucus.

You may be fearful of being on the breathing machine, because you will be unable to speak. 

Rest assured that your nurse will be close by at all times. Your nurse can read lips and will ask you specific yes or no questions such as “Are you in pain?” 

The nurse can also monitor your heart rate, blood pressure, and facial expressions as measurement of pain and anxiety. Remember—much of how we communicate has nothing to do with speaking.

You will most likely experience some pain after surgery, however every person is different. 

Your doctor will order pain medication as needed to help you manage any pain. The pain medication will not completely take the pain away, but your walking and breathing exercises will also help you to lessen any pain.

Follow our top tips for pain management with medication, and you’ll be managing your pain effectively in no time. 

• Don’t wait too long to ask for your pain medication. Let your nurse know that you are hurting, where you are hurting, and the severity of pain.
• Pain medication can cause an upset stomach when taken on an empty stomach.  Take with food.
• Keep WALKING and MOVING.Use your incentive spirometer (breathing machine) every hour.
• Use a pillow to hold firmly against the incision.
• Use the pain scale to help you communicate your pain in few words to your healthcare providers. Simply rate your pain on a scale of 0 to 10, with 0 indicating no pain and 10 indicating severe pain.

After the breathing tube is taken out, your nurse will allow you to have small amounts of ice chips to evaluate your swallowing. 

Once it’s safe to eat and drink, you will start on clear liquids (which consist of Jell-O, popsicles, coffee, tea, juices, and some chicken or beef broth soup). If you’re having difficulty swallowing, you may need to be evaluated by a speech-language pathologist, to determine any issues and risks with your swallow function. Your nurse will let you know the amount of fluid you can have because you may be on a fluid restriction.

After surgery you will be connected to special equipment to monitor your blood pressure, heart rate, heart pressures, and other numbers that your physicians and nurses evaluate to care for you after surgery. 

The machines often make beeping sounds or noises, which is normal. You will also be connected to IV pumps and tubing. For your own safety and care, please do not attempt to remove any tubes or wires.

After surgery you will have one or more tubes inside of your chest cavity that were placed during surgery. 

These tubes drain excess air and blood from the chest. They are connected to a box-type container, called a Pleur-evac. At times the Pleur-evac may make a bubbling noise. 

The tubes remain in your chest until your surgeon feels comfortable that they can be removed.

You may also have small wires in the lower portion of your chest attached to a pacemaker. These are called pacemaker wires and are inserted while you are in surgery. 

These wires are inserted because sometimes the heart beats slowly after surgery and needs a temporary pacemaker to ensure a healthy heart rate.

Yes, you will have a catheter in your bladder following surgery to measure your urine output. 

You may still feel the sensation of having to urinate, however your nurse will be there to remind you that this tube is still in place. The catheter will be removed when your surgeon feels it is appropriate.

Following your surgery, you will have a small tube in the artery in your wrist called an “arterial line”. This line monitors your blood pressure, and assists with drawing blood for labs, glucose checks, and oxygenation monitoring. 

When the arterial line is removed, your nurse will hold pressure on your wrist and then a bandage will be applied.

You may require insulin after your surgery. In some cases, the stress of surgery and medications may cause your blood sugar level to increase, even if you are not diabetic. 

Because of how often the nurses have to check your blood glucose level, you may find it hard to sleep for long periods of time.

After the breathing tube is removed and your breathing is stable, you will be assisted to sit on the side of the bed. 

We will help you to move to the chair in your room for all meals when you are ready. It is extremely important for you to move and increase your activity as soon as possible.  

The cardiac rehabilitation nurse or physical therapist will show you how to safely increase your activity, starting the day after your surgery.

Most patients remain in the Critical Care unit for between 24 to 48 hours. Your time in Critical Care will vary, depending on your needs, progress, and medications that you require after surgery.

Although a few of the monitoring devices will be removed before you are ready to leave the Critical Care unit, you may still have a large IV port remaining in your neck area. 

It is very important not to touch this IV or attempt to remove the dressing. Your heart will continue to be monitored with a small box that is able to fit inside your gown pocket.