All About Surgeries and Procedures

What Should You Do Before the Surgery or Procedure?

Start planning these things as soon as you have a date for the surgery or procedure.

What to bring:

• Your photo ID at the time of registration
• All medical insurance information, like insurance cards and forms. It is important to know ahead of time what your insurance covers. Check to see if you must be approved before the surgery or procedure. Call (614) 722-2055 for questions about insurance or billing.
• All legal guardianship or custody papers, if it applies
• Adults, age 18 and over, should bring a copy of advance directives if they have one.
• A favorite comfort object. This could be a pacifier, toy, or blanket.
• List of all medicines and doses

Visitors:

• Only 2 visitors over the age of 18 are allowed at one time.
• Please arrange care for any other children.

Transportation:

• People scheduled for a surgery or procedure must arrange for someone to drive them home afterward.
• If the patient doesn’t have a way to get to and from the surgery or procedure center, tell your nurse or someone on your care team. They can help arrange transportation.

Vaccines and Illnesses:

• Because vaccines can cause a mild fever or illness, when possible, avoid vaccines 2 days before and 2 days after the surgery or procedure. If the patient has had any recent vaccines, tell the nurse during the patient call.
• For safety reasons, we may need to reschedule the surgery or procedure if the patient gets sick. You can help prevent an illness by staying away from anyone who is not feeling well and by washing your hands well. Call your surgery or procedure location before if the patient is ill, has a rash, or has a sore throat.

Talking About the Surgery or Procedure

Hospitals can be less scary if you know what’s going to happen. Talking to your child about surgeries or procedures ahead of time can help. Tell them as much as they can understand and encourage questions. Let your child make choices, when possible. It’s important to stay calm and confident. Children can sense your feelings.

Nationwide Children’s Hospital offers tours for some surgery and procedure centers. Ask your doctor, nurse, or health care provider for information.

• Infants – These babies depend on caregivers fully. Bring something they know that has a familiar sound or smell. Show them the equipment and play peek-a-book with the masks.
• Toddlers – These children are learning to explore the things around them. Talk to them 1 to 2 days before the surgery or procedure. Use simple words and read books about coming to the hospital. They may act out before coming to the hospital.
• Preschool-age – These children have active imaginations and may feel the hospital is a punishment. Talk to them 2 to 4 days before the surgery or procedure. Explain why they’re going the hospital using simple words. Explain that the surgery is not their fault and that it’s okay to be scared.
• School-age – These children are learning how to do what is expected of them. Talk to them 1 week before surgery. Use simple words to describe the order in which things will happen. Have your child talk to other kids that have had been to the hospital. Let them explain how they understand what will happen in their own words.
• Teens – Privacy is very important to these children. Talk to them honestly and clearly about the surgery or procedure at least 1 week before. Include their friends and give them as much control as possible, including asking their own questions.

The Night Before

• Make sure the patient washes well with a fresh bar of soap or liquid anti-bacterial soap. Give special care to all the creases in the skin (skin folds). Rinse all areas well. Dry well with a clean towel. * The doctor doing the surgery or procedure may have specific directions on how to clean the skin ahead of time.
• Remove all nail polish and acrylic nails.
• Remove all jewelry, body piercings, subdermal implants, hair braids, beads, and extensions. If extra time is needed for any of these, please plan ahead.
• Shampoo and rinse hair with water.
• Do not use lotions, creams, or powders on the skin.
• Do not shave the area where the surgery or procedure will be done.
• The patient should dress in freshly washed clothes.
• Pack a box or case to hold contacts and removable appliances (glasses, retainers, hearing devices).

What Happens the Day of the Surgery or Procedure?

• If the patient is under 18, a parent or legal guardian must come with the patient.
• Staff will go over the health history and do an exam before the surgery or procedure.
• For safety reasons, do not bring food or drinks.

Anesthesia

Anesthesia (anesthetics) is medicine that prevents the feeling of pain during a surgery or procedure and keeps you from remembering.
A few types of anesthesia are:

• General anesthesia – keeps a person completely “asleep” (unconscious) during a surgery or procedure.
• Local anesthesia – numbs only the surgical or procedure site.
• Regional anesthesia – numbs a larger area of the body including the surgical or procedure site(s).
• More than one of these may be used.

* If you have questions about other kinds of anesthesia, talk to the anesthesiologist. They will choose the safest form of anesthesia to use.

Patient Comfort

The patient’s comfort is very important to the staff at Nationwide Children’s Hospital. Pain management usually starts during the surgery or procedure and may continue after, if needed. Types of pain management and medicines include intravenous (IV), oral liquid, tablets or pills, and medicines that numb the surgery or procedure site.

Talking to the anesthesiologist

An anesthesiologist will talk to you about anesthesia and answer any questions you may have.

Medicine before anesthesia

Some patients worry about the possibility of getting shots before a surgery or procedure. There may be different reasons for getting medicine before a surgery or procedure.

• Your child may be given medicine before anesthesia if they’re nervous or anxious. It will help calm them. This is called sedation. It is usually given as a liquid to drink.
• Teenagers and adults may have an intravenous (IV) cannula placed in a vein for an injection if sedation is needed for anxiety.
• Talk to the anesthesiologist about your choices.

How anesthesia is given

• In most cases, younger children inhale medicated air through a mask that covers the nose and mouth. The patient may choose a scent for the mask. After 1 to 2 minutes, they will be asleep (anesthetized). After that, an IV will be placed to give fluids and medicines.
• Older children, adults, and some children with medical problems may need IV medicines to “go to sleep” instead of the air mask. You may get to choose what you’d like depending on the situation. The anesthesiologist will make the final decision based on what is safest and discuss it with you.
• A member of the anesthesia team will stay with the patient during the entire surgery or procedure to make sure they are safe. They will watch breathing, heart rate, blood pressure, and oxygen levels (vital signs).

Recovery

The patient will wake up and recover in the post anesthesia care unit (PACU). The PACU nurses are specially trained in this type of care. An anesthesiologist is always close by if there are any problems. Recovery times are different based on the surgery or procedure. The goal is to have the patient awake and back with family as soon as safely possible. If you have any questions or concerns during or after the surgery or procedure, ask staff.

What Happens After the Surgery or Procedure?

The doctor will talk to you after the surgery or procedure. The nurses will answer any questions and give you step-by-step verbal and written instructions for follow-up care. * Results of any radiology scans during the surgery or procedure will be reviewed later.

Symptoms after surgery

Some people will be sick to their stomach (nauseous) or may throw up (vomit). Children having eye surgery or tonsillectomies are more likely to have this problem. If this happens, medicine can be given for the nausea and vomiting.

Other things to expect

If a breathing tube was put into the mouth and throat, the patient may have a sore throat
or hoarseness for a few days. There may be a small puncture mark or bruise where the IV was removed. There may be more than one puncture mark if it takes more than one try to get the IV placed.

Possible behavior changes

Children handle the experience in different ways. It’s common for them to:

• Start doing behaviors they used to do (regress).
• Have trouble being away from you.
• Become more dependent on adults than they were before.
• Have changes to their sleeping and eating patterns.

These changes usually don’t last long. If you have any questions or concerns, call the phone number in your discharge instructions.

Preventing Infection

An infection can happen on or in the body where a cut (incision) was made during a surgery or procedure.

• Call the doctor right away if the patient has any of these symptoms of a site infection: redness, pain gets worse, cloudy drainage, or a fever of 101° Fahrenheit (F) 38.3° Celsius (C) or higher.
• Help prevent infection by:
  • Always cleaning your hands before and after caring for the incision(s).
  • Staying away from anyone who is not feeling well. This includes close family.
  • Not letting anyone else touch the incision(s).
  • Visitors should clean their hands with soap and water or an alcohol-based hand gel before and after visiting.

How Do You Stay Safe After a Surgery or Procedure?

It’s normal to feel sleepy and/or unsteady after getting anesthesia.

To prevent injuries:

• For babies and young children:
  • One adult should ride in the backseat with the child while a second adult drives.
  • Use a car seat or a booster seat before and after the surgery or procedure, as age appropriate.
  • Watch and help your child after the surgery or procedure.
  • Do not let your child use a vehicle or ride a bike for 24 hours. This time may be longer depending on the doctor’s orders.
  • Quiet, indoor activities are best.
• For teens and adults:
  • Arrange for someone to be with you for the rest of the day.
  • Do not sign important documents for 24 hours.
  • Do not use a vehicle or ride a bike for 24 hours. This time may be longer depending on the doctor’s orders.
  • Quiet, indoor activities are best.

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^{Helping Hands™ are easy-to-read guides about different illnesses, therapies, surgeries, and more. They’re created by the Patient Education team at Nationwide Children’s Hospital and are reviewed and approved by clinical staff, like nurses, doctors, pharmacists, and psychologists. Nationwide Children's Hospital is not responsible for misuse of information in patient education materials, including Helping Hands.}

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