If your cardiac surgeon sends you to PAT, the following information applies to you. If not, please skip this section.

PAT is located on the second floor of the Medical Plaza East building near the circular admitting desk. Several things will need to be done prior to your heart surgery.

• An admission assessment is done by a nurse who will ask about your medical history, past surgeries and medications you are taking.
  
  
• Your surgeon may order any of the following tests listed:
  

  EKG (electrocardiogram)

  Chest X-ray

  Blood work

  
  
• Signing permission for surgery.
  
  
• Anesthesia assessment- you will be seen by someone who will be responsible for putting you to sleep during your surgery.
  
  
• Respiratory- a respiratory therapist will begin preoperative teaching so you will know what to expect while in the hospital.
  
  
• Allow about 1- 1 1/2 hours in PAT to have everything done.

This is an excellent opportunity to ask any questions you may have about your surgery.

The Night Before Surgery

If You Are In The Hospital Or At The Pre-Hospital Inn

• An admission assessment is performed by a nurse who will ask about your medical history, past surgeries, and medications you are taking.
  
  
• A chest x-ray, EKG, and blood work may be done.
  
• Preoperative teaching is done by the nursing staff.
  
  
• You and your family will watch a program to teach you about your heart surgery. Refer to the TV schedule on this website for more information on cardiac videos to watch. If you have any questions, be sure to ask your nurse.
  
  
• Respiratory Therapy will visit and discuss their role in your surgical recovery.
  
  
• The surgeon will visit if you have not already seen him.
  
  
• You will scrub thoroughly with special soap from your chin to your toes.
  Give extra attention to the chest, groin, and legs when scrubbing.
  
  
• If you do not already have one, an IV will be started (unless you are staying at the Inn).
  
  
• Nothing to eat or drink after midnight.

If You Are At Home

• You and your family will view parts 1 and 2 of the video you have been given with this notebook.
  
  
• Be sure to scrub thoroughly with the special soap from your chin to your toes. Give extra attention to the chest, groin, and legs when scrubbing.
  
  
• Nothing to eat or drink after midnight.

The Day of Surgery

If You Are In The Hospital Or At The Pre-Hospital Inn

• Scrub again thoroughly from chin to toes. Give extra attention to the chest, groin, and legs when scrubbing.
  
  
• Someone will come to shave you from your neck down.
  
  
• Medications to help you relax may be given before you go into surgery.
  
  
• Once you leave your room, you will be taken to the Holding Area.

If You Are At Home

• Scrub again thoroughly with the special soap as you did last night.
  
  

• Bring your Heard Education notebook( if you received one)with you to the hospital in the morning.

• Go to the circular desk on 2nd floor in Medical Plaza East to check in.

• Someone will guide you to your room.

• Once you leave your room, you will be taken to the Holding Area.

During Surgery

• Your family will go to the Family Waiting Area on the 1st floor.

• A family member should sign-in at the desk.

• One family member should remain in the Family Waiting Area until they receive a call from Surgery.

About The Family Waiting Area

• A brochure describing the Family Waiting Area is available.
  
• Free phones are available for local calls.
• If needed, a locker is available for belongings.
• Drinks and snacks are allowed.
• Please check in daily with staff members so they may locate you for phone calls or messages. If you leave the area, please inform the staff where you may be reached. The Family Waiting area staff is available to assist you from 6:30 a.m. until 9:00 p.m. weekdays and 7:00 a.m. to 9:00 p.m. on weekends
• The phone number in the Family Waiting Area is (615) 222-2103.

During Surgery

• Once you are asleep, an incision will be made. In most cases, it will start above your breastbone and end just below it.
  
  
• You may have incisions on one or both of the insides of your legs. Veins are generally taken from the legs to bypass the blockages in your heart.
  
  
• There will be catheters and IV lines placed during surgery in both your arm and your neck. These monitor your blood pressure and allow fluids and medicines to be given easily.
  
  
• Tubes will be placed in your upper abdomen to allow drainage of excess fluids or blood. Bloody drainage is normal.
  
  
• A catheter will be placed in your bladder to monitor your urine output.
  
  
• Temporary pacemaker wires are placed in your chest. These may or may not be used to regulate your heart rhythm after surgery. These wires are taped to your chest when not in use. Before you go home they will be removed.

Immediately After Surgery

• You will wake up in the Critical Care Unit (also called the Pods).
  
  
• Your family will be notified in the Family Waiting Room when your surgery is completed. The doctor will talk with your family about the surgery at that time. When you are settled in your room, your family will be allowed to visit.
  
  
• Your family should expect you to look pale and a little swollen. Your family will see improvement with each visit. It is also important to know that there will be many monitors and lots of sounds such as beeping and bubbling.
  
  
• You will not be able to talk due to the breathing tube in your mouth.
  
  
• Since you will be very sleepy, your hands will be gently tied with soft restraints. This will keep you from accidentally pulling out any tubes.
  
  
• As soon as you are awake enough, the breathing tube will be removed and then you will be able to talk.

After The Breathing Tube Is Removed

• For a while, you will not be allowed to eat or drink. When your condition allows, you will be progressed from liquids to solid food.
• Expect to be assisted up to a chair shortly after the breathing tube is removed
• Deep breathing, coughing, and getting out of bed are key to avoiding complications after surgery. Therefore, pain relief is very important in helping you with these activities. The nurse will offer you medication to avoid severe pain; but not all discomfort can be totally relieved.
• A Respiratory Therapist will assist you in using your incentive spirometer every 2 hours in Critical Care.

Other Things To Know About Your Critical Care Stay

Family may visit at certain times; visits are for 15 minutes each.

Patients usually transfer to a less-intensive area called Telemetry (on either the 3rd or 4th floor) within 24-48 hours of surgery. Visitors are welcome until 9:00 p.m. on Telemetry and one visitor may stay with you all night.

Telemetry

• You will be connected to a small cardiac monitor that allows you to move, sit in the chair, and walk around freely while still having your heart monitored.
  
  
• It is common to have some irregularities or fluttering in your heart beat after surgery. If you have any questions, call your nurse.
  
  
• Cardiac Rehabilitation (Rehab) normally begins the first day you arrive on Telemetry. You will quickly progress to walking at least 4 times a day. You will sit up in the chair at least 2 times a day. You should walk with the Rehab staff 2 times during the day and then with your nurse or a family member at suppertime and bedtime. Your target is 4 times total each day.
  
  
• You can expect to feel exhausted after any major surgery. The fatigue will gradually decrease over the next few weeks.
  
  
• You will continue to cough, deep breathe, and use the incentive spirometer every 2 hours while you are awake. Your family's assistance in helping you remember to do this is important. Your nurse will check on your progress.
  
  
• Hugging a pillow to your chest will make coughing easier.
  
  
• It is important to ask for your pain medicine. It is not brought to you without your asking for it first.
  
  
• Some shortness of breath and soreness is usual.
  
  
• Your diet will begin to include more solids but don't be concerned if your appetite has not returned to normal. This is expected and will gradually get better.
  
  
• A frequent complaint after surgery is the inability to get a good night's sleep. This may be related to the surgery itself and to your medicines. Over time it should improve.

  About Visitors

  Visitors are welcome anytime up to 9:00 pm. Short visits by two people at a time are encouraged. One person may spend the night in your room. That person must register at the central desk and get a visitor's pass.

  Children under the age of 8 are not permitted to visit without special permission first. They must remain in the care of a responsible adult at all times.