Preparing Your Child for Surgery

Anna Tielsch-Goddard CPNP-PC

Life may bring unexpected events to our lives, and one of them may be surgery. Surgery of any kind can be very scary and stress provoking for children and parents.  However, being prepared will help alleviate additional stress for caregivers and help the child relax for the upcoming surgery as well.

Parents should never hide from the child that he or she will have surgery. Children benefit from honesty and simple explanations of what will happen to them when they arrive at the hospital. Children will cope best if they know what to expect.

Let your child ask any questions he or she might have and try your best to answer them with simple explanations. For example, "The doctor needs to take a special picture of your head," if your child is getting an MRI, or "The doctor and nurses are going to fix your ears today," if the child is scheduled for ear tubes. Books about surgery or the hospital can be very useful in preparing children for surgery or helping them understand their diagnosis. Make sure to tell your child that he will get special medicine called "anesthesia," so that he will not feel anything or have any pain during the surgery.

Medical play may also help children prepare for their surgical day. Children from 1-4 years old may benefit by pretend medical equipment toys. Allow them to examine a stuffed animal or doll. School aged children (5-12 years old) can prepare by looking at pictures of what will take place that day. For example, pictures of the hospital or of the preop room which can usually be found on the hospital website.

Try to keep your child's routine as close to normal as possible the day before surgery.

Medical preparation

You may need to bring your child in for blood or urine tests prior to the scheduled surgery; however, not all children need preoperative testing. If your child is taking any medications, including those over-the-counter, talk to your primary care provider or surgeon about taking these medications before surgery.

Most hospitals will call you to let you know when they want your child to stop eating and drinking, usually the night before surgery. Do not let your child eat or drink anything (this includes chewing gum or sipping water) after these times or the surgery will most likely get canceled. This precaution is to reduce the possibilities of complications from anesthesia, such as aspiration pneumonia, which can be caused from having liquids in the belly while being put to sleep.

If your child has a fever, respiratory (lung) infection, or rash a week or two before their scheduled surgery, the surgery may need to be postponed. Call your surgeon’s office to ask.

Make sure you find out if your child will be staying overnight after the surgery or going home. Arrange for a ride to and from the hospital if you do not have transportation.

Day of surgery

Bring a familiar item with your child such as a blanket or special stuffed animal.  School age children might benefit from something to distract them, such as a word game, puzzle, or some drawing materials.  Have your child dress in comfortable clothes to feel more at ease. The child will have to change into a hospital gown or scrubs after arriving at the hospital or surgery center.  Remove any jewelry or metal your child might have including hair clips and earrings.

Make plans for at least one parent to be with your child for the surgery and possible hospital stay.

Preparing yourself as a parent/caregiver

Although every hospital or outpatient surgery center is a little different, there are some main things that you can expect that are universal. On the day of your child's surgery, you should arrive at the time you were told or slightly earlier. You will be checked in and your child will get an ID bracelet that he or she must wear during the entire hospital stay. A nurse or medical assistant will take vital signs, which are a temperature, a heart rate, a blood pressure reading, and a respiratory rate. They will also obtain a current weight on your child.

Your child will have a presurgical assessment which consists of a history and physical examination usually done by a nurse practitioner or physician assistant. Sometimes your child may have already had the presurgical assessment prior to the day of their surgery. You will meet with your surgeon and anesthesiologist who will explain exactly what they will be doing and have you sign an informed consent form. This is your time to ask any questions you might have to the doctors including any potential complications, length of the surgery, and recovery time after the procedure.

Your child may be given Versed, which is a pre-op medication sometimes called "silly juice" or "goofy juice." Versed will make your child drowsy and less anxious to help her not remember leaving you when she is taken to the operating room. Versed is not given to all children and is usually prescribed on a case-by-case basis.

When your child is taken back to the operating room, you will be escorted to a waiting room or the post operative area where you will meet with your child after the surgery. Your child will never be left alone while in the operating room. There will always be a doctor, nurse, or other medical staff with your child. Your doctor will meet with you when the procedure is over to tell you how the surgery went and give you post operative instructions, such as a pain medication prescription or antibiotic, directions on how to take care of the wound, and when to come back for a follow-up. In some cases, you may need to spend the night at the hospital. (You will usually know this before the day of the procedure).

Many children's hospitals employ Child Life Specialists, clinicians, who meet with kids and help alleviate specific fears or concerns relating to their health such as surgery or the hospital. You can call ahead and ask if your surgical center will have a Child Life Specialist available.

Always ask your doctor, nurse practitioners, and nurses any questions you might have and what to expect for your child's procedure. Some hospitals and outpatient surgery centers will allow you and your child to come and view the rooms and where the preoperative assessment areas are so that your child can become familiar with the facility before their procedure.

Recommended Readings:

Bridwell, Norman: "Clifford Visits the Hospital"
Jennings, Sharon: "Franklin Goes to the Hospital"
Zelinger, Laurie: "The "O, My" in Tonsillectomy and Adenoidectomy: how to prepare your child for surgery, a parent's manual"

Further Readings:

Preparing your child for surgery.http://kidshealth.org/parent/system/surgery/hosp_surgery.html

Preparing a child for surgery. https://www.chp.edu/CHP/P03032

Preparing for Your Child's Surgery and Anesthesia ... A Parent's Role http://www.aana.com/ForPatients.aspx?id=325

ANNA TIELSCH-GODDARD CPNP-PC Anna Tielsch-Goddard CPNP-PC is a Pediatric Nurse Practitioner for Children’s Medical Center Dallas at Legacy. She practices on the Perioperative Surgery teams in both presurgical assessment and pediatric-surgery.