I’ve written about what to ask before surgery and how to get your child ready for surgery. But what will the day of surgery actually be like? Knowledge is a great way to combat fear and anxiety. Let me walk you through the steps your child will go through (for elective surgery).
1. Prior to surgery, you will meet the surgeon in the office to determine if surgery is needed. You will be able to ask the surgeon questions about the procedure.
2. You will schedule the operation with the office staff. They will check with your insurance company so you can get an idea of how much your out-of-pocket expenses will be.
3. The day prior to surgery, the operating room will call you and tell you:
a. What time you need to arrive. Unless you are the first case of the day, your start time will be flexible, but you want to be sure to be there on time in case there is a chance for you to start early.
b. When your child needs to stop eating and stop drinking. Nobody enjoys fasting, but having an empty stomach makes surgery much safer. If you go into the OR with a full stomach, you risk vomiting and sucking that vomit into your lungs (aspiration) which can make you very sick or even dead.
c. They may ask some screening questions about your child’s medical and anesthesia history to make things simpler the next day.
4. The day of surgery you will arrive at the scheduled time. You will check in and have your ID and insurance verified.
5. You will go to a pre-operative holding area. Your child will change into a gown. You may be given special antibacterial wipes to clean the surgical area. Depending on the age and anxiety level of the child, your child may be given a sedative medication to take by mouth. You will meet the anesthesiologist and be able to have any questions you have about anesthesia answered. You will see the surgeon and have a chance to ask any last minute questions. The surgeon will use a pen to mark the site of surgery if that is needed. You will meet the OR nurse.
6. Kiss your kiddo goodbye, your baby will now roll back to the OR with the team. Most children are calm and curious for this part.
7. Once your child arrives in the room, the OR nurse will announce your child’s name and the procedure is announced to the rest of the OR team.
8. Your child will either move under his own power or be lifted onto the OR table.
9. Once on the table, a safety strap is applied as well as monitoring devices like EKG leads to check the heart and a probe to measure the oxygen level of the blood. Every step of the way the OR team will explain what is going on to your child.
10. The anesthesiologist will give your child a mask to breathe through that will provide oxygen and an inhaled medicine to put him to sleep.
11. Once he is asleep with the inhaled medicine, one of the team will start an IV. This gives a route to administer fluids and medications.
12. The anesthesiologist will give a combination of medicines through the vein. These usually include:
a. A benzodiazepine (drug like valium) that causes amnesia and sedation
b. A narcotic which helps with pain and sedates
c. A drug that causes paralysis to relax your child’s muscles
13. The anesthesiologist then inserts a breathing tube into your child’s lungs.
14. The OR nurse will make sure your child is safe for the operation: strapped in, padded, eyes taped shut.
15. The surgical site will be cleaned with betadine or chlorhexidine to kill bacteria.
16. The surgical site will be draped with sterile towels.
17. Once the drapes are in place the whole OR team participates in a “Time-Out.” This verifies that they have the correct patient and are set for the correct procedure.
18. Once the operation is done and the bandages applied, the anesthesiologist will wake the baby up and remove the breathing tube.
19. Your child will go to the recovery room (often called PACU for Post Anesthesia Care Unit).
20. The surgeon will come to talk to you about how everything went and go over post-operative care with you.
21. The nurses will get you to be with your child once he is awake.
22. You and your child will leave the PACU and go to a step-down unit to wait until your child is ready to go home. Once your child can take liquids by mouth and his pain is well-controlled, the nurse will check you out. The nurse will discuss:
a. When you are to follow-up with the surgeon
b. What you are to do to care for the wound and/or bandages
c. What medications to take
d. What problems to watch for and what to do if they occur