Preparing your child for surgery or hospitalization

Coming to the hospital can be a scary time for children and parents alike. One of the hardest things for children to understand is that something that hurts or feels strange is actually helping them. Anticipation and not knowing can make it worse. With some preparation, the hospital stay may be made much easier—for both child and family. Obviously, how much your child understands will depend on age and maturity.

Children's visit before surgery or procedure
Because Yale-New Haven Children's Hospital (YNHCH) understands your concerns about surgery and anesthesia, we organized the Preadmission Visit program for you and your child. The program includes a tour of the Pediatric Surgery Center (and inpatient unit if your child is to be admitted) prior to the day of the surgery or procedure. During the visit, we will familiarize you and your child with the whole process, explaining who you will meet and what your child will experience the day of the procedure.

Children can touch and play with the medical equipment they will see on the day of their procedure. They will also be given age appropriate information about how the equipment is used.

A parent's role in preparation
Parents can be helpful by being careful about the words they use to describe hospital procedures. For example, instead of saying "put to sleep" when talking about anesthesia, you can talk about receiving a special sleeping medicine. Pay careful attention to how pediatric staff explain shots and other procedures during the Preadmission Visit and try to use the same language. If you are unsure about what may happen, it's better to say that you don't know instead of promising a child something that later turns out to be false.

If you have other children, be sure to explain, as best you can, what will be happening. Hospitalization affects the whole family, so be prepared for concern on the part of siblings.

Parents should also:

• Encourage your child to express feelings, fears and fantasies. Let your child know it is okay to cry.
• Listen to your child's questions and answer the questions honestly.
• Pack familiar books, toys and clothes your child can take to the hospital.
• Visit the hospital ahead of time through a scheduled preoperative visit.

The day before surgery
Please call the Pediatric Surgery Center 1 - 4 p.m. the day before your child's procedure. At that time, you will learn:

• The exact time of your child's procedure.
• The time you should arrive at the surgery center (one hour before the procedure).
• When to stop eating and drinking.

If your child takes medication regularly, ask the nurse at the surgery center if your child should take medication on the day of surgery.

What to eat or drink before surgery
Following these guidelines is extremely important for your child's safety. Surgery will be cancelled or postponed if the diet guidelines are not followed. Children sometimes do not understand why they cannot have breakfast. Although we know what your child is feeling, we have to put your child's safety first.

Why are these guidelines so important? Anesthesia should be given on an empty stomach. Children (and adults) are at risk of vomiting while under anesthesia. If your child has food in his or her stomach and vomits, food can go into the lungs and cause serious problems. Normally, when a child is awake, he or she will cough if this happens. But while under anesthesia, the body is completely relaxed and not able to cough to clear the lungs. If your child's stomach is empty, this is less likely to happen while under anesthesia.

Guidelines
For children 12 months of age and older:

• No solid food after midnight on the night before surgery. This includes milk, formula, candy and chewing gum.
• Only the following clear liquids can be taken until two hours before surgery: water, sugar water, Pedialyte and apple juice.

Please do not give any other liquids. Stop ALL liquids two hours before surgery.

For children younger than 12 months of age:

• Milk and/or formula can be taken until six hours before surgery.
• Breast milk can be taken until four hours before surgery.
• Water and/or Pedialyte can be taken until two hours before surgery.

Stop ALL liquids two hours before surgery.

Coming to the hospital
On the day of surgery, you should arrive at the YNHCH one hour before the procedure (directions). Valet parking is available for pediatric outpatient surgery patients and is free on the day of surgery only. There is a charge at other times. Families bringing children for inpatient surgery may also use valet parking, but there is a fee. The Pediatric Surgery Center is located on the third floor of the Children's Hospital.

So that everything goes smoothly the day of the procedure, we ask that you follow these guidelines.

Please bring with you the following:

• Results of blood work, if done at an outside lab.
• Insurance information, including forms and identification card.
• A list of your child's medications.
• Copy of court papers designating legal guardianship, if necessary.
• Favorite toy, stuffed animal, blanket, pacifier, sippy cup, bottle.

Please DO NOT bring other children.

You will be with your child at all times before surgery. Once your child goes into the operating room with the anesthesiologist, you will stay in the waiting room and be notified when the surgery is over. You will be reunited with your child once he or she is in the Post Anesthesia Care Unit (PACU). Your child will be in the PACU until he or she is either discharged home or admitted to a pediatric unit.

Returning Home
Most of the surgeries performed on an outpatient basis require very little care at home. You will be given instructions by your surgeon and a nurse upon your child's discharge. If you have questions once you get home, you can call the Pediatric Surgery Center at (203) 688-7996 until 7 p.m. You will receive a follow-up telephone call the next business day to check up on your child's recovery. If you have other questions about the surgical procedure or other concerns, please call your surgeon and/or pediatrician. If you think your child is having problems and you cannot reach your doctor and need help or advice right away, go to the emergency room nearest you.

Returning home can also be an adjustment. Your child may be eager to get back to the usual routine, but a little uncertain of how to proceed.

When your child is leaving the hospital, some simple steps may help make the adjustment to home as easy as possible.

• Return the child to his or her regular home routine and give him responsibilities that match or her abilities.
• Offer him some other choices over what to eat or do.
• Permit the child to express anger, frustration or sadness, and offer reassurance and support.
• Avoid leaving the child for long periods of time or overnight until your child has settled in.
• If you have any problems after arriving home, please call your child's surgeon.

• YNHH Health Library: The Child Having Surgery

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Last revised: June 7, 2007 (dh)

Home page URL: http://www.ynhh.org

All information is intended for your general knowledge and is not a substitute for medical advice or treatment for specific medical conditions. You should seek prompt medical care for any specific health issues and consult your physician before starting a new fitness regimen.