INTERPRETING PEDIATRIC CARDIAC SURGERY

Alejandra E. Picado

THE HEART OF THE MATTER:

1. 1. How to prepare for a cardiac pre-operative interpreting session. (Knowing your terms, procedures, and common preparations, as well as the emotional

preparations.)

2. 2. What the most common pediatric cardiac conditions are, and what the procedures are to repair these.

3. 3. How to interpret with professionalism, while also showing compassion and helping in what little ways we can.

4. 4. Working with the chaplains, child-life and social workers for the difficult conversations prior to surgery.

5. 5. How interpreting a Pediatric cardiac surgery is different from adult cardiac surgeries.

What Participants Will Learn From Today’s Presentation.

So, As Medical Interpreters, We are Here to Serve as …

• Cultural broker. • Support,• Communication manager.• Open heart

What Is The First Thing That Comes to Mind When You Say “Open Heart Surgery?”

Terror, Anger, Desperation, Confusion!

Being briefed before the encounter can make a world of difference to both you and the encounter.

Take note of the environment and silently assess.

Pre-session.

How Do You Begin A Cardiac Pre-Operative Interpreting Session?

Very Common Terms For Interpreting Cardiac Surgery Are As Follows:

Catheterization Heart Lung bypass machine Chest tubes Pacemaker wires Steri – strips Sternotomy / Mini-Sternotomy

The Session Will Begin With possible…

urine tests blood tests echo-cardiogram (ECG) electro-cardiogram (EKG)Cardiac Catheterization

What Are Some of the Most Common Cardiac Defects / Diagnosis in Pediatrics?

1. PDA (Patent Ductus Arteriosis)2. ASD (Atrial Septal Defect)3. VSD (Ventricular Septal Defect) 4. AV Canal (Atrioventricular Septal Defect)5. Coarctation of the Aorta6. TOF (Tetralogy of Fallot)7. AS (Aortic Stenosis)8. HLHS (Hypoplastic Left Heart Syndrome) 9. Single Ventricle Anomalies

PDA (Patent Ductus Arteriosis)

Allows blood to flow from the pulmonary artery to the aorta. 1.) Patent Ductus Arteriosis 2.) Ligated PDA

ASD (Atrial Septal Defect)

A hole between the 2 upper chambers of the heart

VSD (Ventricular Septal Defect)

A hole between the right and left pumping chambers of the heart.

AV Canal (Atrioventricular Septal Defect)

To make it simple: You have 4 apartments. 2 upstairs and 2 downstairs. the whole middle wall is missing.

AVSD Top view of Valve Repaired AV-Canal

Coarctation of the Aorta

Is a narrowing of the aorta, the main blood vessel carrying oxygen-rich blood from the left ventricle of the heart to all of the organs of the body.

Repairs: End to End AnastomosisBypass (Sub-Clavian Flap Repair)Thoracotomy (incision on left side)

Coarctation Coarctation Repair

Tetralogy of Fallot (TOF)An anomaly that refers to a combination of four

related heart defects that commonly occur together.

1. Pulmonary Stenosis2. Right Ventricular

Hypertrophy3. Overriding Aorta4. VSD (Ventricular Septal

Defect)

AS(Aortic Stenosis)Aortic Stenosis refers to a condition that causes obstruction to blood flow between the left ventricle and the aorta.

Valvar AS

Subvalvar

Supravalvar

HLHS (Hypoplastic Left Heart Syndrome)

Several abnormalities of development occur on the left side of the heart in HLHS:• Mitral stenosis (poorly formed) / Mitral atresia (not formed)• Left ventricular hypoplasia.

Aortic stenosis Aortic atresia).

• The main artery leaving the left side of the heart, the aorta, is underdeveloped.• Coarctation of the aorta

Normal Hypoplastic Left Heart

• Norwood • Bidirectional Glenn • Fontan

Different Procedures to Repair HLHS (Hypoplastic Left Heart Syndrome)

1st Repair 2nd Repair 3rd Repair

Only one of the two ventricles is of adequate functional size.

Some of the anomalies described as single ventricle defects include:

Tricuspid atresia –Hypoplastic left heart syndrome– Double inlet left ventricle– Many of the heterotaxy defects-Some variations of double outlet right ventricle –

Single Ventricle Anomalies

Working with Child LifeChild life has a very important role in the hospital. They don’t just “play” with the children, but rather, they role play and make the children comfortable enough to be able to discuss or at least understand in terms that they can comprehend, what all the scary stuff is about.

Working with Social Work and Chaplains

Social workers are a very vital in the preparation for pediatric cardiac surgery.

• Resources• Loving and support

Chaplains play a very important part in the families experience in the hospital.

• Spiritual and Moral Support• Ear to listen with

Keeping the Professionalism while still showing compassion and heart.

Even though we as interpreters should always maintain our poise and remain professional, we can’t lose sight of the fact that we are human beings.

Why is this important?

The main differences of interpreting for adult cardiac surgery and pediatric cardiac surgery.

• Matter of Fact• Less detailed explanation of procedure.• More serious

• Softer Tones• More illustration and breaking down of terms.• Less serious, more relaxing

Interpreter Self Care

We often forget to take care of the most important factor in order to interpret.

Mentally prepare

Spiritually prepare

Deep Breathing

Ask for Support

Connection with Peers or Colleagues

Pamper yourself

Create your own self-care list

Take care of YOU!

THE END

and….The Beginning!

Lead with your heart!