Information For Having Pediatric Surgery at Patient's Hospital..
Going to the hospital for an operation is a common childhood experience. However, if your child is scheduled for an operation, you are probably feeling a little bit nervous – no matter how simple the operation may be.
At Patients’ Hospital, our staff has been specially trained to meet the needs of children and their families. We know that our young patients and their parents or guardians have many questions about what happens at the hospital. We have written this booklet to help you and your child prepare for a visit to our hospital.
Children learn how to manage life’s bumps and bruises by watching and listening to their parents. That’s why your support now - before the operation – is so important. On the following pages, you will find suggestions on how to help your child get ready for surgery. We also encourage teens to read this booklet, ask questions and take an active role in their care
PLEASE NOTE:
If your child becomes sick within the week before surgery, call your surgeon’s office. Health changes that are important include fever, rash, cold or flu symptoms. You should also call if your child is exposed to chicken pox, measles, strep throat or other such illnesses within three weeks before surgery.
What to do before surgery:
After your child goes home:
Preparing Yourself:
The more you know about your child’s operation, the more helpful and reassuring you can be. Here are some ideas to help you get ready for your child’s surgery.
Ask your surgeon or your family doctor about your child’s condition and surgery. Ask questions such as;
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• How long will my child be in the hospital? |
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• How will my child look or act after surgery? |
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• How will their pain be controlled? |
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• What type of care will my child require at home? |
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• When can my child return to normal activities? |
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Read books and brochures about your child’s condition and operation.
Take care of yourself. Eat right and get plenty of rest before your child’s surgery. Your child will count on you for support and comfort.
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Preparing Your Child:
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• Will it hurt? |
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• Can my mom and dad be with me? |
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•How will I go to sleep? |
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• When will I wake up? |
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These are a few of the questions asked by children facing surgery. With good information, you can answer many of your child’s questions.
What to tell a child about an operation depends on his or her age, emotional maturity and coping abilities. Keep in mind the following information when talking to your child about surgery.
When to talk to kids:
Toddlers
Very young children need little preparation. They do, however, quickly pick up on parents’ feelings. Knowing about your child’s operation will give you confidence. If you are confident, your child will be reassured. For toddlers, begin talking about going to the hospital on the day of or evening before the operation.
Preschool and young school age children
Talk to your child about going to the hospital two or three days in advance of the operation. This gives him or her time to think it over and to ask questions.
Older School-Age children and adolescents
Discuss the operation with your older child as soon as the surgery is scheduled. About four to five days prior to surgery, talk with your child again about questions they have. Let your child make as many decisions about the process as possible. Also respect his or her need for some control over who is told about the operation.
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How do I talk to my child about surgery?
Be honest – If your child asks a question that you can’t answer, say that you don’t know, but you will try to find the answer to their question.
Use Familiar words – Use words that your child understands and that are non-threatening. For example, use “sore” instead of pain. When describing an anesthesiologist you might say “sleep doctor”.
Talk about how the surgery will help your child - Let them know that activities and school can be scheduled around their needs.
Let your child know that you will be at the hospital during the operation that they will see you when they wake up and that you will take them home afterwards.
What do I tell my child about surgery?
The following are just a few of the question that your child may ask before surgery. For more help in responding to their concerns, call your child’s surgeon or the hospital.
Will it hurt?
You might say, “It won’t hurt during the operation because the sleeping medicine protects you. But afterwards the place where you had your operation may feel sore. The doctor or nurse can give you medicine to help the soreness go away”.
Who will do the operation?
You might say, “Doctors and nurses will do the operation. They will take good care of you and keep you safe the whole time. You will meet your nurse and sleep doctor before the operation”.
Why can’t I eat or drink before my operation?
You might tell your child, “The sleeping medicine works best when there is no food in your tummy. After the operation, you can eat when you feel hungry”.
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Ideas to help Your Child Cope:
What other ideas and activities can help my child cope?
Tell your child to bring a favorite toy, pacifier, book, blanket or other treasured item with them to the hospital. Help us prevent the spreading of germs to our surgical patients, please be sure that any items brought into the hospital are clean.
Let your child make choices before and after surgery when appropriate. For example, ask your child to pick which clothes/pajamas they would like to wear to the hospital or which favorite item or toy to bring.
Encourage your child to draw pictures as a way to express his or her thoughts and feelings about the surgery. Ask them what they were thinking about when they drew the picture.
Encourage your child to “play doctor” and talk about the upcoming operation. Use a doll or stuffed animal as the “patient”. This type of play will give you insight into your child’s thoughts and feelings.
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For Brothers and Sisters:
Talk to them about their brother or sister’s operation. Use words that they can understand and that are non-threatening.
On the day that you come to the hospital, your child that is having surgery will need all of your attention. It is best to find someone to care for your other children away from the hospital.
After the surgery is completed, we will call you into the recovery room to be with your child as they wake up. It is very important that you do not leave the building. Please let our staff know where you will be, so that you can be there as your child is waking up from anesthesia.
Please note:
Siblings who are sick CANNOT be permitted in any pre or post surgical area or the hospital in general. Germs are easily spread and can be harmful to patients having operations
Ask someone to care for brothers and sisters on the day of surgery if possible
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Registration and Financial Information:
Precertification
Insurance companies require that all non-emergency operations be approved before they occur. Approval is handled by your surgeon’s office. To avoid any financial risks, ask your surgeon’s office to call your insurance company for approval as soon as your child’s operation is scheduled.
If you do not have health insurance or other financial assistance, please call our Business Office at 225-8700 ext 333. The office is open Monday through Friday from 8am to 5pm.
Registration
You probably received an admissions packet from your child’s surgeon’s office. This packet includes some of the registration information that we will need for admission. Please complete the information and forms in this packet prior to the day of surgery.
Be prepared to bring the following information on the day of your child’s surgery:
* Insurance Card
* Child’s Social Security number
* Parents’ Social Security number
* Legal documents concerning guardianship if you are not the child’s natural parent
Your Hospital Bill
Your hospital bill includes charges for hospital services. You will also receive separate bills from each doctor who gives your child care.
Insurance
Payment of your bill is your responsibility. If you give us your health insurance company name and your individual and group policy numbers, we will bill your insurance company. You must pay for services not covered by your insurance, such as deductibles and co-payments. These payments are preferred at the time of service unless you have made prior arrangements with our Business Office. For your convenience, Patients’ Hospital accepts Visa.
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Anesthesia Information:
What is anesthesia?
Anesthesia is the medicine your child will receive that lets him or her go into a deep sleep for the operation. She or he will not feel pain and will not remember the operation.
Who is the anesthesiologist?
At Patients’ Hospital, our anesthesiologists are doctors who are specially trained in both adult and pediatric anesthesia. They will ensure that your child receives the best care.
You will meet with your child’s anesthesiologist on the day of surgery, unless you request a pre-admission visit.
How do I know my child will be safe?
Your child’s anesthesiologist will monitor your child the entire time they are under anesthesia. Monitors constantly check on your child’s blood pressure, heart beat and oxygen levels.
What are the side effects of anesthesia?
Side effects can include sleepiness, irritability, nausea, vomiting, sore throat and a hoarse voice. Most of these side effects are not serious and will go away within a few days. Your child may also be uncoordinated for up to 24 hours after his or her operation.
Why should children not eat or drink before anesthesia?
Problems can occur when food or drink is inhaled during the induction of anesthesia. Carefully follow your doctor’s directions for when your child should stop eating and drinking before the operation to prevent problems. If your child eats or drinks too close to the time of the operation, surgery may have to be rescheduled.
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No Eating or Drinking Guidelines:
The guidelines for eating or drinking before surgery are called “NPO” guidelines. NPO is a short way of saying the Latin phrase “nil per os” meaning “nothing by mouth”.
It is VERY IMPORTANT for toddlers and children to follow no-eating and drinking guidelines before surgery. An empty stomach will keep children from “breathing in” food or drink when anesthesia is given.
Your surgeon or his office staff will give you special instructions about when your child should stop eating and drinking before surgery. General guidelines followed at Patients’ Hospital for children are:
1. STOP all solid foods at MIDNIGHT
2. STOP Infant formula 6 hours before surgery
3. STOP Non-human milk 6 hours before surgery
4. STOP Breast milk 4 hours before surgery
5. STOP Clear liquids 2 hours before surgery ie.,
Pedialyte White grape juice
Clear broths Gatorade
Cranberry Juice Water
NOT ALLOWED AFTER MIDNIGHT:
Orange or Apple Juice, Food, Smoothies, Candy, Carbonated beverages, sodas, gum
if you have questions or need clarification of NPO guidelines, please call the hospital at 225-8700 and ask for our pre-operative nurse.
An empty stomach helps keep kids safe while they are asleep for their operation.
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Before Surgery:
Pre-op telephone interview…
A few days prior to your child’s surgery, you will be contacted by our pre-op nurse. Please allow plenty of time for this telephone call. You will be discussing important medical information about your child. Be prepared to give them information such as: What medications your child is taking; Your child’s past medical history and any current medical problems; A list of your child’s medication and other allergies. The nurse will also give you the exact time of your child’s surgery and when you should arrive at the hospital.
if you would like a pre-admission tour of the hospital or visit with an anesthesiologist, you should request it during this telephone interview.
The night before surgery…
it is important that your child get plenty of rest before surgery. Be sure that your child bathes and washes his/her hair. This helps us, and helps your child feel better while recovering.
Be sure your child has a well-balanced dinner the night before surgery. Give him/her plenty to eat and drink just before the food and drink cut-off time. After the cut-off time, be sure that your child has absolutely nothing to eat or drink, not even hard candy, gum, water or ice. Since children forget and may help themselves to food, they will need to be closely watched.
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What To Bring:
• A pacifier
• A blanket or toy
• An empty bottle or child cup
• Car safety seat ( if appropriate)
• Driver’s license or other ID for parent/Guardian
• Insurance Cards
• Proof of Guardianship
What not to Bring:
* Children other than the Patient
* Visitors other than parents or guardians
* Food or drink that your child could access before surgery
* Unnecessary items such as strollers, etc.
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Arrival at Hospital:
Come to Patients’ Hospital at the time requested by your child’s surgeon. This time will be confirmed by our pre-op nurse during your pre-admission telephone interview.
If your child’s surgery time requires you to be at the hospital before 8am, enter the hospital through the front doors facing Eureka Way. There is a doorbell to the right side of the door. For security purposes, our doors are often locked early in the morning. We have a closed circuit TV security system and when you ring the doorbell, the nurses can see you and speak to you. They will remotely unlock the door and you can follow the signs to the nurses’ station.
If you will be arriving after 8am our receptionist, near the front entrance, will assist you.
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What to Expect on the Day of Surgery:
Parents or Guardians
Getting Ready for Parents or Guardians
• When you arrive at Patients’ Hospital, check with the receptionist in the front lobby, or if it is before 8am, enter through the front doors and follow the signs to the nurses station.
• Meet your child’s nurse.
• Complete paperwork and answer questions about your child’s health history.
• Support your child while the nurse listens to his or her heart, checks their temperature and finishes their assessment. Most outpatient pediatric patients will need their blood drawn. If your surgeon requests this, we prefer that this is done before admission at one of our local laboratories. We feel that this will decrease you and your child’s anxiety level before surgery.
• To make time pass quickly and positively your child can play with their favorite toy brought in from home, or chose from our activity cart.
• Meet the operating room nurse and the anesthesiologist.
• Talk with your child’s surgeon. Ask any other questions you may have.
• To eliminate the experience of separation anxiety many of our younger pediatric patients will be given a special oral medication to make them forget their fear and the temporary separation from their parents.
• Because needles are another source of fear, we routinely place pediatric IV’s in the operating room once the child is already under sedation.
Time to Go for Parents or Guardians
• Give your child a hug and let them know that you will see them as soon as they wake up.
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While You Wait...For Parents or Guardians:
Depending on our surgery schedule, you will either wait in the lobby or a patient room. Your child’s nurse will give you instructions where to wait
* Your nurse or doctor will let you know about how long the surgery will last.
* It is extremely important that you stay in the hospital during your child’s surgery.
* There is a coffee cart adjacent to the lobby.
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After Surgery:
• Once your child is in the recovery room, a nurse will come and get you to be with your child as he or she wakes up.
• Bedside chairs are available for parents.
• Remember that children waking up from anesthesia may cry and seem confused. This is a common reaction. You child may also be breathing some extra oxygen—this is normal. If you have any questions, our recovery room nurses can help.
• The doctor will talk with you about the surgery and how to care for your child at home.
• Ask for help from the nursing staff if you would like to hold your child, but are not sure how to go about it because of bandages or equipment.
• It is important to be calm and to soothe your child as much as possible during his/her recovery period.
• After your child recovers, you may get them dressed and take them home, or if they will be staying with us for a few hours, you can go with them to their hospital room.
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After Your Child Goes Home:
Planning ahead….
In preparation for your child’s return home, stock up on clear foods and drinks, such as broth, apple juice, KoolAid, Popsicles, and Jello. Your Child’s appetite should return in 12-24 hours. When your child is ready to try something a little more filling, soft, bland foods can help ease them back to solid foods.
Arrangements for transportation home should be made before discharge. You must have an age appropriate car/booster seat to take your child home in.
At discharge…
When your child is discharged, a nurse or doctor will give you an instruction sheet telling you…
• about prescription medications
• what to do if your child runs a fever or has discomfort
• how to care for the incision (if applicable)
• when normal activity can be resumed
Behavior changes after surgery…
Children of all ages may behave differently after surgery.
• Young children may need more attention and may act cranky and demanding. They may have nightmares, poor appetites and bathroom accidents, even if they are toilet trained.
• Older children may regress, test limits or become withdrawn or clingy.
These behavior changes are normal, especially for young children who have limited ability to understand and talk about their operation. For most children, behavioral changes after an operation are temporary lasting a week or two at most.
Kids may be uncoordinated or confused for up to 24 hours following surgery and anesthesia. Be gentle in easing them back into their usual activities.
Support your child’s return to a normal routine by
- being understanding
- setting gentle limits
- encouraging independence
- giving them opportunities to play and talk about their
- operation
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