Preparing for Your Child's Surgery
Any medical procedure is a big event in a child's life. Studies show that children cope better with medical procedures when they are well prepared ahead of time.
There are many ways parents can help make an upcoming procedure easier for their child.
- Answer your child's questions honestly.
- Put your child at ease by showing your confidence, not your concerns.
- Listen to your child's comments and be sensitive to hidden fears.
- Assure your child that illness and medical treatment are not punishments.
- If you have any fears or anxieties about the procedure, discuss them with your child's doctor away from your child and before the day of the procedure.
- If possible, make arrangements in advance for the care of any brothers or sisters on the day of the procedure. You will want to focus on caring for the child who is having the procedure.
- If possible, make arrangements to have two adults present the day of surgery. This will ensure plenty of help when caring for your child at the facility and on the ride home.
- One adult present must be the child’s legal guardian. This person will need to sign the consent forms. Procedures cannot be done if these forms are not signed.
- Continue to take prescribed medication up until the night before surgery unless directed otherwise by your doctor. Please refrain from using Ibuprofen, Aspirin or Naproxen two weeks prior to surgery unless otherwise directed by your doctor.
When your child's physician determines surgery is needed at Children's West Surgery Center, you will be given information about our facility and printed instructions for completing a health assessment questionnaire for your child online. It is extremely important that you complete the online health information, as soon as possible, so we may begin to prepare for your child's upcoming procedure.
If you do not have access to the internet to complete the necessary online health information, please notify the surgery center as soon as possible, but preferably no later than 1 week prior to your child's surgery. Call 865-560-0303 and ask for the Pre-admission nurse.
The business day before the scheduled surgery date, the Preadmission nurse will contact you with specific instructions regarding when to arrive at the surgery center and when to restrict your child's eating and drinking. As always, do not hesitate to contact us at 865-560-0303 if you should have any questions.
Day of Surgery
Prior to Admission
What to Bring With You
There will be lots of activity – both at home and when you arrive. The more you plan ahead, the fewer surprises there will be. Before walking out the door to come to the surgery center, check to make sure you have the following:
- A list of questions for the doctor or nurse.
- Any paperwork your child's doctor has asked you to bring on day of surgery.
- Your patient’s insurance card. Remember: This must be the most current card.
- A photo ID for the parent or legal guardian that will accompany the patient.
- Your child's medication list with times your child last received them. Include any and all meds taken the two weeks prior to surgery and "as needed" medication as well.
- Your child's favorite blanket, stuffed animal, doll, book, or pacifier. Older children may want to bring a hand held video game.
- A bottle or sippy cup if used by your child. If your child drinks formula or milk, please bring that with you. The surgery center will provide apple juice, sprite, kool aid, water and popsicles.
- An extra pair of clothes for your child. Dress your child in comfortable clothes. Pajamas are acceptable.
- The night before surgery, your child should have a bath or shower before leaving home to help prevent infection.
- Remove all jewelry (this includes body piercings) and nail polish.
Helpful Hints for Parents When Going to the Surgery Center
- Give your child choices when possible to make him feel more comfortable and in control. For example, let him choose a favorite toy (a blanket, stuffed animal, doll or book) to bring.
- It is very important that you eat. This will help you be the best you can be for your child.
- Smile! Put your child at ease by showing your confidence, not your concerns.
Eating and Drinking Instructions
Before your child's procedure you will be given instructions on when to stop your child from eating and drinking.
- Unless your doctor directs you otherwise, the patient cannot eat any solid food after 11pm the night before surgery (This means not even a piece of gum or hard candy can be given to your child).
- She/he can have formula or milk up to 6 hours prior to scheduled arrival time and breast milk up to 4 hours prior to scheduled arrival time.
- She/he can have apple juice, water, pedialyte, or sprite up to 2 hours prior to scheduled arrival time.
- If you do not follow the eating and drinking restrictions it could cause serious problems and put your child's health at risk.
- Follow these instructions carefully. If you do not, the procedure will be delayed or canceled.
Day of Surgery
- Check in at the receptionist's desk. You will be given directions as to where you should wait.
- A legal guardian must sign surgery consent forms for patients who are under the age of 18 years. Surgery cannot be done if the consent forms are not signed.
- Present your insurance card and parent or guardian photo ID when checking in.
"Pre-Op" is where you will wait before your child's procedure. While you're in the Pre-Op area, we will ask questions about your child's health. We may ask some questions more than once, but this helps us gather very detailed information. We ask that only 2 people accompany the child into the pre-op area as space is limited. One person must be the legal guardian.
- We will weigh and measure your child upon arrival to pre-op.
- Your child will be given a hospital gown that ties in the back. You may leave on your child's underpants, diaper, and socks.
- Toilet trained children will be asked to empty their bladder.
- Female children age 12 years and older or those who have begun menses must provide a urine sample. Please alert the receptionist if the patient needs to urinate prior to admission to the preop area.
- We will listen to your child's heart and check your child's temperature and breathing.
- Jewelry, nail polish, contact lenses, eyeglasses and any metal hair clips must be removed from your child.
- A member of the anesthesia team will ask about your child's medical history.
- Shortly before your child's procedure, he may be given a small amount of medicine to drink. Your child should become very relaxed and may become groggy or wobbly.
- It is important to either hold your child securely or place him on the bed with the side rails up.
- Watch your child carefully and follow the nurse's instructions so he/she does not fall.
- Children 12 years and older may have an I.V. placed in the pre-op area. If this causes anxiety for your child, then the staff will be flexible and discuss concerns with the anesthesiologists
Sometimes there are unavoidable delays in the operating room schedule. Our staff will keep you informed should this happen.
Child Anesthesia Care
Anesthesia is medicine that lets a part of the body, or the whole body, go to sleep before a procedure so the child will not feel anything during the procedure. An anesthesiologist is a doctor who gives the “sleep medicine” to your child.
- A staff member from our Anesthesiology department will talk to you about giving your child anesthesia.
- Anesthesia care services are billed separately from other charges. Please call your insurance company to make sure they will pay for the cost of the anesthesia. You will be billed for costs not covered by your insurance.
- Anesthesia is given to your child using a clear plastic mask that covers his nose and mouth. It may look a little scary, but it is not at all painful.
- Depending on the procedure, your child may be given intravenous (I.V.) medicine and fluids through a tube in his/her arm while he/she is asleep. The I.V. will still be in place when he/she wakes up.
Time for the Procedure
- When it is time for your child's procedure, a member of the Operating Room (OR) team will come to your child's bedside. You will have “hugs and kisses” time with your child, and then a member of the healthcare team will take your child to the OR.
- Your child will not be left alone from this point until he is able to rejoin you. The OR nurse and many others will watch over your child with tender, loving care.
- One adult must stay in the facility at all times while child is in surgery or recovery area. This is so your child's doctor can find you in case there are any questions.
While Your Child is in Surgery
- Depending on what type of surgery your child is having, he may be in the operating room for just a short time or for several hours. Your doctor will tell you how long the procedure should take.
- Your child's scheduled surgery time is an estimate. It is important that we take as much time as necessary with each patient, so delays can occur. If you have any questions or concerns about this, please ask a staff member.
- You can wait for your child in the lobby area.
- If your child is having a procedure that takes more time, one parent can leave the center to get something to eat or to get some air, but one parent or guardian must remain in the surgery center at all times. Tell the nurse if you leave, and please make sure your absence is brief-- your child or the staff may need you.
- While waiting for your child, please begin to prepare for your child’s return by preparing a bottle or having a sippy cup readily available if they use one. Your child will be ready for a drink when you are reunited and may become very agitated if they have to wait while it is prepared.
- After surgery, your child will be taken to the recovery room, where he will be closely monitored. Parents cannot come into this area.
- While your child is in the recovery room, you will meet with your child’s doctor to be given information about the surgery, what to expect with recovery, and possibly given paperwork your doctor would like you to have.
- When your child is ready, they will be brought to the step down area to be reunited with you. At this point they will be awaking from anesthesia and probably still sleepy.
- When your child wakes up, they will be offered clear liquids to drink. Once they are awake and drinking, the I.V. will be removed. If your child has a favorite cup, sippy cup, or bottle please bring it with you.
- Don't be alarmed if your child acts upset (crying, screaming, thrashing) as the anesthesia wears off. This is a very common effect. It is nothing to be afraid of, and it does not mean that anything went wrong.
- A nurse will write down the information you need to care for your child.
When Your Child Returns to You
- The best way to comfort your child is with quiet words and gentle touches. Most children will probably be somewhat uncomfortable. They may feel sick to their stomachs from the anesthesia. They may be feeling pain that requires medicine.
- The nurses will check your child frequently. They will check your child's wakefulness, ability to drink and keep down liquids, and the need for pain medicine. Your child may feel irritable and even sad. This is normal. Allow them to express their feelings. Treat them with gentleness and understanding.
- Encourage your child to sip small amounts of liquid or to chew on ice chips provided by the nurse.
- Your child may need medicine to help control his pain.
- Please tell your child's nurse if you think your child is in pain.
- Remember to stay calm. Your child will become more agitated if you are upset.
Admission for Overnight Observation
- In the rare event your child needs overnight observation, you will go with him to a room at East Tennessee Children’s Hospital.
- Observation allows your child to have nursing care until your child's doctor decides it is OK for him to go home (or that he needs a longer hospital stay).
- A parent or guardian must stay overnight with the child in the hospital.
Instructions for Care at Home
- Before your child leaves the center, you will be shown how to care for him at home. The instructions will be given to you by a nurse and written down for you to take home. Instructions may include pain medicine, activity level, diet and/or rest.
- Follow these instructions and you may be amazed at how quickly your child is back to his normal activities.
- When your child's doctor says it is OK to go home, we will begin the checkout process.
- We understand that you are eager to go home as soon as possible. We will do all we can to make the checkout go swiftly.
- Check to make sure you have all the personal items you brought with you.
Ready for the Ride Home!
- For his or her safety, your child may ride in a wheelchair when ready to leave the surgery center. They may feel dizzy, so use caution and support when transferring from wheelchair to car and with their activities at home.
Day after Surgery
- You will be contacted by a nurse at the Surgery Center to assess the progress of your child, answer questions you may have, and assess your child’s surgery center experience.
- Remember! If you have urgent concerns about your child, contact your doctor and not the surgery center. The office will have a doctor on call 24 hours a day to answer questions.