HOSPITAL & ACUTE CARE

1. The First Hours & Days: Understanding the Medical Response

When a child suffers an anoxic brain injury, the immediate goal is stabilization—restoring oxygen, preventing further brain damage, and managing complications. Here's what typically happens in the first critical hours and days:

Emergency Interventions

• Ventilator (Breathing Support): A ventilator will assist if your child cannot breathe independently.

• Sedation & Medically Induced Coma: Some children are placed in a medically induced coma to protect the brain from further stress.

• Cooling Therapy (Therapeutic Hypothermia): In some cases, doctors may lower body temperature to slow brain swelling and reduce damage.

• Seizure Monitoring: Anoxic injuries often trigger seizures. If suspected, your child may have an EEG(electroencephalogram) to monitor brain activity.

Imaging & Diagnostic Tests

• MRI (Magnetic Resonance Imaging): Shows areas of brain damage and swelling.

• CT Scan (Computed Tomography): Quickly assesses brain injury and bleeding.

• EEG (Electroencephalogram): Measures brain waves to check for seizure activity.

• Bloodwork: Tests for oxygen levels, infection, and metabolic issues.

What to Ask the Doctors Right Away

• What are the biggest concerns for my child right now?

• Are there signs of brain swelling? What are you doing to manage it?

• Are there seizures, and how are they being treated?

• What's the next step? When will we know more?

2. The Pediatric ICU (PICU): What Happens Next?

Once your child is stable, they will likely remain in the Pediatric Intensive Care Unit (PICU) for days to weeks. This time is crucial as the brain begins its recovery process.

Common Equipment & Monitors in the PICU

• Ventilator & Oxygen Support: If breathing is weak, support may be needed.

• IV Lines & Central Lines: Deliver fluids, medications, and nutrition.

• G-Tube (Gastrostomy Tube): A feeding tube may be inserted if swallowing is impaired.

• ICP Monitor (Intracranial Pressure): Doctors may monitor pressure inside the skull if there is significant brain swelling.

Possible Complications & What to Watch For

• Seizures: Even if your child never had seizures before, they may develop due to brain injury.

• Spasticity or Muscle Stiffness: Oxygen deprivation can lead to tight, rigid muscles.

• Infections: Pneumonia is common due to immobility and ventilator use while Aspiration Pneumonia is common after drowning.

• Heart & Blood Pressure Issues: The brain controls vital functions, so heart rate fluctuations, low blood pressure, or temperature swings may occur.

What Parents Can Do in the PICU

✔ Ask Questions: Don't hesitate to ask for explanations about test results or treatments.

✔ Write Everything Down: Keep a journal of doctor updates, medication changes, and any progress you notice.

✔ Be Your Child's Advocate: Speak up if something seems wrong. You know your child better than anyone.

✔ Take Care of Yourself: Eat, sleep, and step outside when possible. Your child needs you strong.

3. Signs of Improvement vs. Signs of Concern

As days pass, doctors will monitor your child's brain function. Here's what you may see:

Signs of Hope & Healing

💡 Spontaneous movements (hands or feet moving)

💡 Opening eyes (even briefly)

💡 Response to voice or touch (turning toward sound, squeezing a hand)

💡 Improved breathing (needing less oxygen support)

Signs That Require Urgent Attention

⚠️ No changes after several days

⚠️ Frequent seizures despite medication

⚠️ Worsening muscle stiffness or weakness

⚠️ Severe agitation or distress

Recovery looks different for every child, and progress can be slow—but even small steps matter.

4. Preparing for the Next Phase: Rehabilitation or Home Care

Once your child is stable, the hospital team will discuss the next steps. This could mean:

A. Transfer to Inpatient Rehabilitation

• If your child is conscious and showing movement, they may be transferred to a pediatric rehab facility.

• Rehab can include physical, occupational, and speech therapy to rebuild lost skills.

• This phase is critical for maximizing recovery potential.

B. Transitioning to Home with Medical Support

• If your child has severe impairments, they may be discharged with home nursing care, a feeding tube, or mobility aids.

• Some families may need hospice or palliative care support.

C. Long-Term Considerations

• You may need to advocate for therapy services, equipment, and special education support.

• Ongoing neurological follow-ups are crucial to track progress.

5. Emotional Support for Parents & Caregivers

This journey is emotionally and physically draining. Here's how to navigate it:

• Give Yourself Grace

You're doing the best you can in an impossible situation. It's okay to grieve, to cry, and to feel overwhelmed.

• Accept Help

Let family and friends bring meals, sit with you at the hospital, or help with other children at home. You don't have to do this alone.

• Connect with Other Parents

Hearing from families who have been through this can bring comfort, advice, and hope.

• Seek Professional Support

Therapists and support groups can help you process the trauma, stress, and uncertainty that come with this experience. Message us below to find out about qualifying for free mental health services.