Paediatric units normally provide facilities and equipment for mothers of infant patients to pump their breastmilk, which can then be fed to the infant through the NG tube, and/or stored for later use. Oxygen therapy is commonplace for hospitalized d-TGA patients. This may range from an oxygen mask resting on the bed nearby their head to intubation. In some cases, patients are intubated as a precaution; the machine can monitor breathing and supplement the patient as much or as little as they need. IVs are used to deliver medication, blood products, or other fluids to the patient. Arterial lines provide a constant monitor of blood pressure, as well as a method of obtaining samples for blood gas tests; central lines can also monitor blood pressure and provide blood samples, as well as provide a means to deliver medication and nourishment; fingerpricks (or heelpricks on small babies) are used to obtain blood samples for certain tests. A sphygmomanometer may be used for intermittent blood pressure monitoring even if a patient is being otherwise monitored using a central or arterial line. A pulse oximeter is attached to a finger or toe and provides constant or intermittent monitoring of the bloods oxygen saturation level.An EKG creates a visual readout of how well the heart rhythm is functioning. Medication
Prostaglandin (PGE)
Antibiotics
Diuretics
Analgesics
Cardiac glycosides
Sedatives
When PGE is administered to a newborn, it prevents the ductus arteriosus from closing, therefore providing an additional shunt through which to provide the systemic circulation with a higher level of oxygen.Antibiotics may be administered preventatively.
Moderate
Left anterior thoracotomy
Isolated pulmonary artery banding (PAB)
Left lateral thoracotomy
PAB (when coarctation or aortic arch repair also required)
Right lateral thoracotomy
Blalock-Hanlon atrial septectomy
Each of these procedures is performed through an incision between the ribs and visualized by echocardiogram; these are far less common than heart cath procedures. Pulmonary artery banding is used in a small number of cases of d-TGA, usually when the corrective surgery needs to be delayed, to create an artificial stenosis in order to control pulmonary blood pressure; PAB involves placing a band around the pulmonary trunk, this band can then be quickly and easily adjusted when necessary. An atrial septectomy is the surgical removal of the atrial septum; this is performed when a patent foramen ovale (PFO), or atrial septal defect (ASD) are not present and additional shunting is required to raise the oxygen saturation of the blood flowing eventually into the aorta. Major
Median sternotomy
PAB (when intracardiac procedures also required)
Concomitant atrial septectomy
In recent years, it is quite rare for palliative procedures to be done via median sternotomy. However, if a sternotomy is required for a different procedure, in most cases all procedures that are immediately required will be performed at the same time. Monitoring and maintenance
Nasogastric tube (NG tube or simply NG)
Intubation, oxygen mask, or nasal cannula
Intravenous drip (IV)
Arterial line
Central venous catheter
Fingerprick
Sphygmomanometer
Pulse oximeter
EKG
An NG tube is used to deliver nourishment, and occasionally medication, to the patient. Since the tube extends right into the stomach, it can also be used to monitor how well the patient is digesting their "food".