When your child’s surgery is scheduled the nurse will give you a handout detailing what your patient can eat the night before surgery. Typically, older children cannot have anything to eat or drink after midnight the night prior to surgery. Infants cannot have any formula for 6 hours prior to surgery, or breast milk for 4 hours prior to surgery. Children less than 2 years of age can have CLEAR liquids up to 2 hours prior to surgery. It is very important to strictly follow these guidelines to ensure that children do not vomit while under anesthesia and risk choking and lung infection,
The nurse will also tell you if your child is scheduled for an outpatient surgical procedure or an inpatient surgical procedure.
Outpatient procedures are minor surgical procedures that do not require the patient to stay in the hospital overnight. Common outpatient procedures include hernia repairs, circumcisions, and removals of small skin lesions. Occasionally, children who were expected to have an outpatient procedure are asked to stay overnight for observation. This most commonly occurs in children who have difficulty drinking after surgery due to nausea, infants that were born prematurely, or those that take a long time to awaken after surgery.
Inpatient surgical procedures are more complex procedures that require the patient to be admitted the night before surgery or stay overnight after surgery. Common inpatient surgical procedures include pectus excavatum repair (Nuss procedure), ostomy reversal, endorectal pull through, and imperforate anus repair (PSARP).
At the time that your surgical procedure is scheduled you will be notified if your child is expected to stay overnight or not.
On the day of surgery you will first take your child to the Patient Access department (formerly Admitting) to register them. After your child is registered you will go with them to the surgery waiting room. A nurse will come get you and your child from the waiting room and take you to a preop holding room. In the preop holding room the nurse will take your child’s vital signs and ask you questions about your child’s health history. The person who will administer the anesthesia to your child during surgery, an anesthesiologist or certified registered nurse anesthetist, will come check on your child to make sure that they are not sick and are safe to put to sleep. This is also where the surgeon will come see your child prior to surgery to answer any questions that you may have.
When your child is ready for surgery he or she will be wheeled into the operating room in a bed or crib. You can walk with your child in the hallway until they enter the operating room, where only nurses and doctors in special scrubs and masks can go.
While your child is in the operating room you may be given a pager. This pager allows you to leave the surgery waiting room to go outside or to the cafeteria without worrying that you will miss the surgeon when he comes to see you after surgery. When your child’s surgery is complete the buzzer will go off to let you know to return to the surgery waiting room. After surgery the surgeon will discuss the surgery with you and answer any questions. You can then go wait for your child in the recovery room.
After the surgery is complete the anesthesiologist will turn off the medicine that makes your child sleepy. As the child begins to wake up he or she is taken to the post anesthesia recovery room, or PACU. Parents are welcome in the PACU to be with their child as the child wakes up. Every child reacts differently to anesthesia, it is not uncommon for children to become fussy or combative after anesthesia when they are still groggy and confused. Nurses in the PACU will give your child medicine if they appear to be in pain or have nausea. Once your child is awake and is able to drink liquids without vomiting he or she may be discharged home. Your nurse will tell you when to follow up with the surgeon or nurse practitioner after surgery. She may also give you a handout that answers common questions related to your child’s surgery. The surgeon will prescribe appropriate pain medication for after surgery, or let you know if it is ok to use over the counter pain relievers such as Tylenol or ibuprofen. There are also handouts on this website related to common surgeries that may answer common questions. If you have a question not included in the handout or you feel your child has a problem after surgery, call 251-415-1475. A nurse will return your call to answer your question after speaking with the surgeon or nurse practitioner during regular business hours. If you have a problem after business hours the answering service will receive your call and contact your physician. If it is an emergency please call 911.
Some children need to be admitted to the hospital the day prior to surgery to get ready. This includes any sickle cell patient having a surgical procedure and most patients having surgery that involves the intestines. Your child will not be able to eat or drink anything after midnight the night prior to surgery. Your child will have IV fluid that will keep them hydrated during this time. When your child is ready for surgery the transporter will come pick them up from their room and bring them to preop holding. Parents are encouraged to come with their child to keep them calm and answer any questions the surgeon may have. When your child is ready for surgery he or she will be wheeled into the operating room in a bed or crib. You can walk with your child in the hallway until they enter the operating room, where only nurses and doctors in special scrubs and masks can go.
While your child is in the operating room you may wait in the surgery waiting room or in your child’s room. Make sure you let the surgery team know where you are going to they can find you after the procedure is over. After surgery you will be with your child while they wake up in the recovery room, and then they will be moved back to their patient room to rest.
After surgery your child may recover in the pediatric intensive care unit (PICU) or the pediatric unit. Surgeries that require that the patient be closely monitored after surgery, such as pectus excavatum repair (Nuss procedure) or other surgeries that involve the chest may initially go to the PICU for the first few days after surgery. Most patients who stay overnight after surgery will recover on the pediatric unit. These units have specially trained nurses that are experts in caring for sick children.
While your child is admitted to the hospital there are many activities available to keep them entertained and aid in their recovery. Special play rooms separated by age are available to allow your child to check out toys, movies, and games to take back to their room. They can also go to this room to play when they feel well enough to get out of bed. In these play rooms are child life therapists, specially trained people who have experience helping children recover from injuries or illness based on their age and developmental level. There are also fun seasonal activities such as Mardi Gras parades, visits from Santa Claus and the Easter bunny, and pet therapy dogs to make the hospital stay as enjoyable as possible.
The Ronald McDonald house is located on the Children’s and Women’s Hospital campus and is available for families of children who do not live in the Mobile area or will be staying at the hospital for an extended time. One to two adults are encouraged to stay with the child while they are patients at the hospital, but sibling are strongly discouraged from staying overnight for safety reasons. A couch that extends into a single bed is available for parents staying overnight.
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