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Prepare yourself for your child’s surgery. Parents who can control their worries and be as relaxed as possible send the message to their child that everything will be okay.
Talk with your child about his/her trip to the hospital and upcoming surgery. Use simple words that your child understands and be honest. This will help your child trust you and the staff at MEEI. Ask your child what he/she is thinking or feeling about the surgery, and answer any questions you can. Use the following information as a guideline for talking to your child about surgery.
Young children do not understand time the same way older children and adults do. Preparation one month or even one week ahead may be too abstract and may not be helpful, so it is best to talk to your child one or two days before surgery. Help your child feel like he has some control by allowing him to choose a favorite stuffed animal, blanket or toy to bring to the hospital. It is normal for toddlers to become fussy and have changes in their behavior; it is helpful it you can remain calm and patient with your child.
Preschool aged children will benefit from preparation three to four days before surgery. Use simple words to explain to your child what will happen without too many details, as she will most likely be very curious. Preschool age children can have fantasies about the hospital experience and will use their imagination because they do not know what to expect. They often think that they did something to cause the surgery, or they may become angry at parents and caregivers. It is important to tell your child that the surgery is no one’s fault, and that it is OK to tell you how she is feeling. Use soft words to describe experiences. Tell them they may be “sore” and want to say “ouch” instead of saying something will “hurt.” Avoid the term “put to sleep” which could be associated with putting a pet to sleep. You could say “special kind of sleep” or “help you take a nap.” Reading books with pictures of medical equipment and using play medical kits are great ways for your preschool child to explore feelings. (a list of recommended books for all ages is found at the end of this page.)
School-aged children can be told about surgery one or two weeks ahead of time. School aged children often worry that they will wake up during surgery. Explain to your child that there is a doctor whose job it is to make sure that he stays asleep and does not feel anything during the surgery. Your child may also worry that the surgery will change the way he looks, so it is best to give him details about what will happen before, during and after the surgery. Talk to your child about the experience in sensory terms – what he may hear, smell, see, touch, etc. It is normal for your child to become angry or quiet, or to exhibit different behaviors. Be supportive and treat your child as normally as possible.
Involve your teenager in the planning, discussions and decisions of the surgery, as she is very aware of her body and how it works. The biggest worry for an adolescent is how the surgery may change the way she looks and how it will affect daily activities with her friends. Encourage your adolescent to write down or ask any questions she may have. Discuss her fears and be completely honest. Adolescents are looking for more independence, and being in the hospital may make them feel less independent. Help her by giving her some feeling of control during her hospital stay.
Children do better with surgery and anesthesia when they are well prepared. Be honest with your child in a way that is appropriate for their age and personality. Keep in mind their developmental level, as well as any past medical experiences.
Involve your child’s siblings in the preparation activities. This will ensure that they feel involved even though they cannot be at the hospital during the surgery. It is important that you be able to give the child having surgery all of your attention, so we ask that you please leave siblings at home.
Be sure to follow the food and drink guidelines provided to you by your surgeon’s office. Remember not to eat and drink around your child or other children on the Pediatric Unit as they are all not allowed to eat before surgery.
For more information about how to prepare your child for surgery, contact the Child Life Specialist at 617-573-4184. Pre-Admissions Teaching Tours are also available to patients and their families. Please call to schedule an appointment.
Please arrive at the hospital at the time and place (10th Floor Pediatrics or S Floor Surgicenter) given to you by your doctor’s office. This is not the time your child will have surgery, but the time you should arrive to begin preparations for surgery. Please do not arrive early as this will not allow your surgery to begin earlier than scheduled. Please be prepared to dedicate the entire day to your child’s surgery and recovery.
Upon arrival to the MEEI, please take the elevators from the Lobby to either the 10th floor Pediatric Unit or the Surgicenter on the S floor. The day/evening before your child’s surgery you will receive a pre-operative phone call which will clarify the location on your child’s surgery. You do not need to visit the Admissions Desk or the Information Desk unless otherwise instructed.
If your child has a fever the day before surgery please contact your surgeon’s office immediately.
If your child has a fever the morning of surgery contact the Pediatric Unit at 617-523-7900 x2462 or the Surgicenter at 617-523-7900 x2660.
If you feel that you will require an interpreter on the day of surgery, please contact your surgeon’s office ahead of time.
Please do not allow your child to wear any jewelry, body piercings or nail polish on the day of surgery.
Please arrange for other children and extended family members to remain at home so that we can mutually focus on your child who is undergoing surgery.
For patients being cared for on the 10th Floor Pediatric Unit please be aware that your child may or may not be given a menu for dinner at the end of the day. This menu is for patients only. A full service cafeteria is available for parents on the 7th Floor.
You will be interviewed by a member of our Pediatric Nursing Staff who will ask you important questions about your child’s health and will take your child’s vital signs. Your child will then be given hospital pajamas to change into. The Ronald McDonald Learning and Activity Center is available to patients on the Pediatric Unit while they are waiting.
Before going to the Operating Room, you will also meet with the anesthesiologist to discuss the anesthesia plan. You and your child can ask questions and express concerns at any time. If there is the possibility that a parent may be pregnant, please inform the anesthesia staff to determine if it is appropriate to go into the Operating Room.
One parent will be allowed to accompany your child to the surgical floor and into the operating room, at the discretion of the anesthesiologist, and will stay there until your child is asleep under anesthesia. We will provide you with scrubs to wear into the operating room.
You and your child will be escorted down to the surgical area where you will meet the surgeon and surgical team. If family members are waiting for you on the Pediatric floor, please be sure that they know that you will be downstairs for at least 30 minutes, sometimes longer, before your child is given anesthesia. You will then return to the Pediatric floor to wait during the surgery. For patients of the Surgicenter, our waiting room is right outside of the Operating Room.
Your surgeon will contact you on the Pediatric Floor or in the Surgicenter waiting room when your child’s surgery is complete. If you choose to leave the floor during surgery, please take a beeper from the nurses’ station so that you will be reachable when the doctor calls.
Please be aware that our surgical floor cares for pediatric and adult patients in the same area. There is not a separate pediatric surgical or recovery area, but we do our best to give the children their privacy and space to play in.
One parent will be allowed, at the discretion of the anesthesiologist, to accompany your child into the Operating Room to provide support while he or she falls asleep. Your child may ride to the Operating Room on a stretcher, or walk or be carried. For your child’s safety, the nurses will help decide the best way for your child to enter the Operating Room. Your child may bring a stuffed animal, blanket, or pacifier to help him or her feel more comfortable.
The Child Life Specialist or a nurse will show you where to sit so that you do not touch any sterile supplies. Your child will be told to lie on his/her back on the operating room table, and you will be able to sit right next to him/her. You may hear a lot of beeping and different noises in this room. These are from the monitoring equipment and are completely normal sounds.
The anesthesiologist will introduce your child to a soft, see-through plastic mask that will cover your child’s nose and mouth. Small tubes connect this mask to the anesthetic gas that will anesthetize your child for surgery. While your child is breathing through the mask, you can hold his/her hand, and speak soothingly to your child, or sing a favorite song or tell a favorite story. It is important that your child hear your voice as they fall off to sleep.
Older children may have an intravenous (IV) placed before going to the Operating Room. The anesthesiologist will give your child medicine through the IV to help him or her fall asleep in the Operating Room. You can hold your child’s hand and talk soothingly to him or her as he or she is falling asleep.
While going to sleep under anesthesia, your child may display a variety of behaviors, all of which are normal. Your child may giggle uncontrollably, cry or whimper, or you may notice that your child’s eyes become unfocused or roll. Some children struggle as they are going to sleep, while others fall asleep without doing anything. These situations are all possible and are completely normal.
It is likely that your child will not remember much if any of his/her experience in the operating room. It is much harder for a parent to watch than it is for a child to fall asleep.
You can help your child by speaking soothingly, and by stroking or touching your child’s hand, arm, or hair. Even when your child is no longer able to see you, he/she will feel your touch or hear your voice.
The anesthesiologist will tell you when your child is asleep and will ask you to give him/her a kiss on the cheek or forehead. The Child Life Specialist or a nurse will escort you out of the operating room and will direct you back to the Pediatric floor or the Surgicenter waiting room where you will wait during the surgery.
Please remember that you must leave your child’s side when asked to. This can happen at any time if the anesthesiologist feels that it is no longer appropriate for you to be in the room. We understand that it is hard to leave your child, but his/her safety is our primary concern.
After the operation, your child will go to the Post Anesthesia Care Unit (PACU), a room in which to wake up from the surgery and anesthesia. We will make every effort to reunite you with your child as soon as possible. For safety concerns, as well as for your privacy and the privacy of other patients, we are only able to allow one parent at a time in the PACU for each child. You will be contacted on the Pediatric Unit or in the Surgicenter waiting room when it is time for a parent to come to the PACU.
Sometimes children are still asleep when parents come to the PACU, while other children may be awake and confused from the anesthesia. Your child may be receiving oxygen, have an IV, or may be attached to a heart monitor. A nurse will check your child’s heart rate, breathing, blood pressure and temperature as he or she wakes up from surgery. Please ask your child’s nurse any questions you have.
Each child may wake up from anesthesia differently. Some children may be wide awake in the PACU; others may be sleepy and groggy for hours after surgery. Some get very confused and agitated for 10 minutes to one hour. The child may appear to be awake, but is not really aware of what is going on, this is called “emergence delirium.” During this time, your child may cry, thrash or reach for a parent. Nothing seems to calm the child. This may be upsetting to watch but usually goes away by itself. This is sometimes part of the normal awakening process, especially in children under 6 years of age.
Your child’s nurse will make sure that your child is safe. You should try to stay calm and comfort your child. Your child will not remember this excited state and often wakes up feeling fine. If you have questions ask your child’s nurse or doctor.
The nurse in the Recovery room will tell you when it is appropriate for your child to return to the Pediatric floor. Your child will be transported to the floor on a stretcher. For patients in the Surgicenter, the nurses will determine when your child is ready to be sent home.
If your surgeon feels that your child should stay overnight in the hospital, one parent will be allowed to stay with the child. Pull-out beds are located in every room on the Pediatric Unit next to the patient bed. Consider bringing comfort items for your child if they are spending the night.
If your child is going home on the day of surgery, he or she will be discharged from the Pediatric Unit on the 10th Floor or from the Surgicenter on the S Floor. The nursing staff will give you written information about how to care for your child. They will explain the activity, medicines, special care, follow-up appointments, what to expect and whom to call with questions.
The nurses and doctors will decide when it is time for your child to go home. We want you to be confident that your child feels well enough to go home and that you feel comfortable with discharge instructions.
Please arrange for a ride or taxi home before the day of surgery, as your child may still be sleepy and uncomfortable.
Some children exhibit temporary changes in their behavior at home such as changes in sleeping and eating patterns, clingy behavior, hyperactivity, new fears, and
acting younger. This behavior is normal and temporary. You can help your child by:
Remember to talk with your child after going home about their experience in the hospital. Answer any questions in order to deal with any remaining issues or concerns. If you have concerns about your child’s behavior you should contact the surgeon’s office.
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