All About Surgeries and Procedures

The following information is to help prepare the patient for a planned procedure or surgery. Please make sure to call the surgery or procedure center where you are scheduled if you have any other questions about your instructions.

Instructions Before the Surgery or Procedure

One to seven days before the procedure or surgery, a nurse will call you. You may get more than one call. If you have not been contacted by 4 p.m. the day before the procedure or surgery, call the location listed above. During the call, the nurse will get a health history and discuss the following information:

• Current health status – recent or current sickness, like a cough, cold, fever, or rash
• Arrival time – usually 2 hours before the surgery or procedure, depending on the location
• Questions about parking and directions
• How long you should plan on staying at the hospital or procedure or surgery center
• Eating or drinking restrictions
  • There will be food and drink the patient cannot have before the procedure or surgery.
  • It is very important to follow the directions to avoid any problems (complications).

If you do not follow the eating and drinking instructions, the procedure or surgery may need to be canceled and rescheduled for another day. Ask your nurse and health care provider for information about your eating and drinking instructions.

Planning for the Procedure or Surgery

The following are things you can start organizing and planning as soon as the procedure or surgery is scheduled.

What to Bring

• All medical insurance information, like insurance cards and forms. You will need to present your photo ID at the time of registration. You are responsible for being aware of, and in compliance with, your insurance policy requirements. Be sure to check to see if insurance pre-certification is needed ahead of time. If you have questions about insurance or billing, call (614) 722-2055.
• All legal guardianship or custody papers, if this applies
• Adults, age 18 and over, should bring a copy of advance directives if they have one.
• If your child is having a procedure or surgery, bring a favorite comfort object. This could be a pacifier, toy, or a blanket.
• List of all medicines and dosages

Visitors

• Please limit visitors to two adults at a time.
• Please make other arrangements for the care of siblings.

Transportation Arrangements

People scheduled for a procedure or surgery must arrange for a designated driver to take them home afterward.

Vaccinations and Illnesses

• Because vaccinations can cause a mild fever or illness, avoid vaccinations one week before and one week after the procedure or surgery. If the patient has received any recent immunizations, please let the health care team know during the patient call. If there are any questions about this, contact your location.
• For safety reasons, we may need to reschedule the surgery or procedure if the patient becomes ill. You can help prevent an illness by staying away from anyone who is ‘not feeling well’ and by practicing good hand washing. Make sure to call the doctor’s office if the patient is ill, gets a rash, or develops a sore before the surgery or procedure.

Talking to Your Child About Surgery

Hospitals can be less scary if you know what is going to happen while you are there. Talking to your child about their surgery ahead of time can help with this. Tell your child as much as they can understand and encourage questions. Let your child make choices, when possible. You have a very important role in this process. Stay calm and confident. Children can sense your feelings. Nationwide Children’s Hospital offers separate tours for Main Operating Room, Main Campus Surgery Center, and Westerville Surgery Center. Ask your nurse or health care provider for information on the tours.

The Night Before Surgery or Procedures

• Make sure the patient washes well with a fresh bar of soap or liquid anti-bacterial soap. Give special care to all the skin folds. Rinse all areas well. Dry well with a clean towel.
• Remove 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 in advance.
• Shampoo and rinse hair with water.
• Do not use lotions, creams, or powders.
• Do not shave the area where the procedure or surgery will be done.
• The patient should dress in freshly washed clothes.
• Make sure to pack a box or case to hold contacts and removable appliances.

The Day of the Procedure or Surgery

• If the person having the procedure or surgery is under 18, a parent or legal guardian must come with the patient.
• Our staff will go over the health history and do a brief exam before the procedure or surgery.
• For the patient’s safety, please do not bring food or drinks.

Anesthesia

Anesthesia (anesthetics) is medicine that prevents the feeling of pain during a procedure or surgery and prevents you from remembering. Nationwide Children’s Hospital staff specializes in giving anesthesia to infants, children, and adults. They will choose the safest form of anesthesia to use. A few types of anesthesia are:

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

Patient Comfort

The patient’s comfort is very important to the staff at Nationwide Children’s Hospital. Pain management usually starts during the procedure or surgery and may continue after the surgery or procedure if needed. Types of pain management and medicines include:

• Intravenous (IV) medicine
• Oral liquid
• Tablets or pills
• Medicines that numb the procedure or surgery site

Getting Anesthesia

All general anesthetics are provided by members of the Department of Anesthesiology and Pain Medicine. The anesthesia staff includes doctors specializing in anesthesia (anesthesiologists) and certified registered nurse anesthetists under the direct supervision of the anesthesiologists.

Talking With the Anesthesiologist

An anesthesiologist will talk to you about the anesthesia and answer any questions you may have. If you have any questions or concerns about the anesthesia before the day of the procedure or surgery, please call the phone number listed for your location.

Medicine Before Anesthesia

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

• If your child is nervous or anxious before the surgery or procedure, a sedative may be needed before anesthesia. It is usually given in the form of liquid to swallow.
• Teenagers and adults may have a catheter placed in a vein (intravenous cannula) for an injection if sedation is needed for anxiety.
• Talk to the anesthesiologist about options.

How Anesthesia Is Given

• In most cases, younger children inhale a non-irritating, medicated air through a mask that covers the nose and mouth. Your child may choose a scent for the mask. After 1 to 2 minutes, your child will be asleep. After your child is asleep, an intravenous (IV) catheter will be placed so fluids and medicines may be given.
• Older children, adults, and some children with medical problems may need IV medicines to “go to sleep” instead of the air. You may or may not get the chance to choose what you would 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 procedure or surgery to watch 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 procedure or surgery. The goal is to have the patient awake and reunited with family as soon as safely possible. If you or your family have any questions or concerns during or after the procedure or surgery, please ask staff for an update.

After the Procedure or Surgery

The doctor will talk to you after the procedure or surgery. The nurses will answer any questions and give you step-by-step verbal and written instructions for follow-up care.

*For any radiology scans, results will be given and discussed at a later time.

Symptoms After Surgery

Some people will be nauseated 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. At times, there may be more than one puncture mark because it may take more than one try to get the IV in place.

Possible Behavior Changes

Children handle the experience in different ways. It is not uncommon that your child may:

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

These changes are usually short-term. If you have any questions or concerns, please talk to the doctor at the phone number written on your discharge instructions.

Preventing Infection

A procedure or surgical site infection can happen on or in the body where a cut was made during a procedure or surgery.

• Make sure to call the doctor right away if the patient has any of these symptoms of a site infection:
  • Redness
  • Increase in pain
  • Cloudy drainage
  • Fever of 101 degrees F (38.3 degrees C) or higher
• You can help prevent infection by:
  • Always cleaning your hands before and after caring for the wound(s)
  • Not letting anyone else touch the wound(s)
  • Staying away from anyone who is not feeling well. This includes close family.
  • Visitors should clean their hands with soap and water or an alcohol-based hand gel before and after visiting.

Staying Safe After Procedures and Surgeries

It is not unusual to feel sleepy and/or unsteady after getting anesthesia. To prevent injuries:

• If the patient is a young child:
  • We highly recommend that one adult ride in the backseat with the child while a second adult drives home.
  • Use a car seat or a booster seat before and after the procedure or surgery, as age appropriate.
  • Watch and help your child after the procedure or surgery.
  • Do not allow your child to operate a motorized vehicle or ride a bike for 24 hours. This time may be longer depending on the doctor’s orders.
  • Quiet, indoor activities are best.
• If the patient is a teen or an adult:
  • Arrange for someone to be with you for the rest of the day.
  • Do not sign important documents for 24 hours.
  • Do not operate a motorized vehicle or a ride a bike for 24 hours. This time may be longer depending on the doctor’s orders.
  • Quiet, indoor activities are best.

Surgery and Your Child (PDF)

HH-I-154 6/93, Revised 9/19 Copyright 1993, Nationwide Children’s Hospital