Your Child's Cardiac Surgery at American Family Children's Hospital
Welcome to the American Family Children’s Hospital
Getting ready for your child’s surgery is very important. It involves much more than lab tests and clinic visits. It’s knowing what to expect before and after surgery. Also, it is a process of gaining confidence and believing that all will go well.
Before your child’s work-up visit, please read this booklet. Write down any questions and bring them with you to the visit. Please bring this booklet with you. Your nurse will review it with you and answer your questions.
Preparing Your Child
A visit to the hospital may be new and perhaps scary for a child. One of the best ways to help prepare your child for this event is to thoughtfully explain what will happen before the day of surgery.
All children are unique. When and how to talk with your child depends on the child’s age and personality. Use language your child knows and allow him to ask questions and express concerns. Younger children should be told about surgery close to the event. A toddler may be told the day before. A school age child could be told the week in advance. Give basic information. Answer your child’s question the best you can.
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If you are unsure about what to tell your child, child life specialists at AFCH can help you and may be reached at (608) 890-7888.
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What to Expect during Your Child’s Work-Up Visit
You can expect the work-up to take 4 hours. You will meet with many members of the health care team during this time. Your child will have some tests (electrocardiogram, chest x-ray, blood tests) performed. Bring medical records, recent history and physical forms, immunization records, X-rays, and any other test results to the work-up visit.
You may also meet with a child life specialist. She can talk with you about going into the OR until your child is sleeping. You will also discuss how you can be helpful during the hospital stay. Your child will have a chance to see medical play equipment. You will be given a tour of the Pediatric Intensive Care Unit (PICU).
There are also online tours of American Family Children’s Hospital that can be found at :
http://www.uwhealth.org/american-family-childrens-hospital/american-family-childrens-hospital-video-tours/12411
You will be asked to sign a consent form showing that you understand and wish your child to have the surgery. You will also meet with the anesthesia staff.
At some point during the day, you will need to stop at the Admissions Department to verify your insurance.
Before Surgery
You will be given the time for your child's surgery the day before the surgery (or on Friday before a Monday surgery). A nurse will call you at your home or place of work. She will let you know when to arrive and answer any questions that you might have. If you do not hear from us by 2:00 pm, please call (608) 890-8000 and ask for the 3rd floor AFCH surgical services.
If your child has been exposed to chicken pox, has a cold, fever, or other illness the day before surgery, please call (608) 263-0439 between 8 a.m. and 4:30 p.m., Monday through Friday.
If it is after hours the night before surgery and your child gets a fever, come as scheduled and your child will be examined with the understanding that surgery will be cancelled.
To help things go smoothly, please follow these instructions.
1. Ibuprofen (such as Children’s Motrin® or Advil®) and herbal supplements should be stopped 14 days before surgery. Plavix should be stopped 7 days before surgery. Aspirin (and medicines which contain aspirin such as Pepto Bismol®) should be stopped 5 days before surgery. Coumadin® and warfarin should be stopped 3 days before surgery. If your child takes any of these medicines, please let your surgeon or nurse know. Acetaminophen (Tylenol®) may be used if needed for pain or fever.
2. The night before surgery, shower or bathe your child with a special antibacterial soap. This soap will be given to you in the clinic. Avoid getting it near your child’s eyes or genitals. Do not apply lotion to your child’s skin after the shower. The soap will be given to you at clinic.
3. The night before, your child will need to stop eating solid foods at midnight. Also, no candy or chewing gum. Your child will need to stop drinking milk and formula 6 hours before surgery. If you are breastfeeding, the last feeding should be finished 4 hours before surgery. Two hours before surgery, your child will need to stop drinking clear liquids (apple juice, water, or Pedialyte®). This will prevent stomach contents from getting into your child’s lungs.
4. Your doctor may want your child to take some of her normal medicines on the morning of surgery. These should only be taken with a sip of water.
5. When your child brushes her teeth, she may rinse and spit, but not swallow any water.
6. Remove all makeup and nail polish. Remove all jewelry, and for safe keeping, please keep at home.
7. Always bring any inhalers your child may use for lung conditions.
8. Your child should try to have a restful night before surgery. If you are coming from out of town, you may find it helpful to stay in Madison the night before. A Ronald McDonald House is nearby for children and families who receive care at the American Family Children’s Hospital. A housing coordinator, (608) 890-8000, can arrange for your stay there or provide you with a list of nearby motels where you can get a discount rate. You may also stop at the Guest Depot on the first floor of AFCH. After hours, please call (608) 263-8591.
If your child has a favorite toy or blanket please bring it (labeled with your child’s name) to comfort him while in the hospital. You may also bring some of your child’s own pajamas or comfortable clothing for him to wear once transferred out of the intensive care unit. You may also want to bring reading materials or something for yourself to do while your child is hospitalized. A television, DVD player, and CD player in your child’s room can be used at no charge.
9. Please bring along glasses, hearing aids, or other special devices your child may need. Include any special feeding devices or the nipple or drinking cup your infant or toddler prefers. Be sure these items are labeled with your child’s name.
10. Leave large sums of money at home. Bring a small sum for miscellaneous expenses.
11. All school age children may attend the Hospital School if they wish. You may want to arrange with your child’s teacher to bring along some homework.
The Day of Surgery
Please arrive by your scheduled time.
- Park in the AFCH Ramp (map in back cover of this book)
- Upon entering the AFCH Ramp, you will receive a parking stub. Please bring it with you to get it stamped. Do not leave it in your car. Parking is free.
- Take the elevator from the parking ramp to Level 1.
- Get your parking stub stamped at the Security Desk or Guest Depot, located on level 1.
- Take the AFCH elevators (marked with
) up to Level 3. - Check in at the Reception Area.
Since your child is under age 18, a parent or legal guardian must remain in the hospital during surgery unless special arrangements have been made with the anesthesia and nursing staff.
In the Operating Room
One parent may be able to go with your child into the operating room. If you choose to go with your child and the anesthesiologist agrees with this plan, you will be asked to change into a protective gown and hat. A child life specialist or nurse will go with you and your child. You may touch and talk to your child while she falls asleep.
The room will be brightly lit. A nurse will be there to explain what is being done. Once in the room, your child will be moved to a narrow, firm bed with a safety belt much like a seat belt. A blood pressure cuff will be put on your child’s arm. Sticky patches will be placed on her chest to watch her heartbeat. A special tape or lighted clip will be put on her finger or ear to check the oxygen level in the blood.
Once the anesthetic has taken effect, you will be shown to the waiting area. A nurse will call the waiting area with updates during the surgery. Your child’s doctor will talk with you after the surgery.
After Surgery
Your child will be taken to the Pediatric Intensive Care Unit (PICU). Your child may also be placed on a breathing machine (ventilator). Your child will not be able to talk while the breathing tube is in his windpipe. As he begins to wake up, the nurses will be able to communicate with him very well despite this. Once awake, older children should be able to nod “yes” and “no” or use a notepad to write brief messages until the tube is removed. The breathing tube may be taken out within an hour or longer.
Soon after the breathing tube is removed, your child will be asked to breathe deeply, cough, and use the incentive spirometer or blow bubbles to exercise the lungs. The child will learn how to do these simple lung exercises during the clinic visit.
Nursing staff members must be with your child the first time he gets up. The child may need some help for a few days. Even though the child may feel weak and sore, he needs to get out of bed and walk. This helps to decrease any lung problems.
Your child will be unable to eat right after surgery. At first, the child will be given fluids and nourishment through an IV (intravenous) line. Over the next few days, the child’s diet will progress from clear liquids (Pedialyte®, juice, or gelatin) to full liquids (formula, milk, ice cream) to solid food.
More details about what to expect will be discussed during the work-up visit.
About American Family Children's Hospital
Your child will be taken to the Pediatric Intensive Care Unit. While here, your child will likely take part in the activities offered daily in the playroom, schoolroom, and recreation room. Until then, activities can be brought to the room.
Having a parent present can be a comfort to a child in the hospital. Once your child is settled in the PICU, you are welcome to be with your child as much as you wish. Because you know your child best, you are a valued member of the health care team. Plan to take part in your child’s care as much as you are able.
In the PICU, parents are welcome to stay at the bedside. One parent is allowed to sleep in your child’s room. There are also sleep rooms located in the PICU that are available as needed. For persons other than primary caregivers, visiting hours are from 9:00 AM - 9:00 PM. Because children are often busy with treatments and cares during the day, late afternoon and evening are the best times for friends to visit. There is a family kitchen equipped with a refrigerator and microwave available for your use. You may also purchase food from the cafeteria.
Dealing with Pain
Our goal is to help your child have as little pain as possible. Even so your child may have some pain. These tips may be helpful to you and your child.
- Ask the nurse or doctor what kind of pain your child might have, and what can be done to help ease your child’s pain.
- Talk with your child about how to describe and rate pain.
- Older children may be able to use a number scale where 0 means no pain at and 5 means the worst pain.
- Younger children can be taught to use the pain face scale where the face above 0 means no pain and the face above 5 means the worst pain.
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- Help the nurses and doctors assess your child’s pain. Let them know what helps to make your child feel better.
- Pain medicines may cause your child to become drowsy, dizzy, or lightheaded. Do NOT allow your child to drive, drink alcohol, or do jobs that requires him to be alert. Some medicines may cause constipation. When your child goes home, he needs to drink plenty of fluids – water or juice – and eat foods rich in fiber.
While medicines are often used to treat pain, other comfort measures (e.g., quiet or gentle touching) can also help to prevent and control pain. Nurses and doctors will work with you to ease your child’s pain after surgery.
There are a number of benefits of good pain relief. Your child’s comfort is improved. His sense of well being will be enhanced. And, overall recovery may be improved. Children who have good pain relief appear to do better after heart surgery.
Going Home
How long your child stays in the hospital depends on the type of surgery. Before leaving, you will meet with the heart surgery care team, and we will talk with you about how to care for your child at home. A discharge planner will talk with you about any special needs your child may have at home
You will also receive prescriptions for any medicines your child will need. These can be filled here, if your insurance allows, or at your local drugstore. Please bring your insurance card if you plan to fill your prescriptions at the AFCH pharmacy.
You may want to have someone else drive the car so that you can attend to your child on the way home. Also, be sure to arrange to have your child's car seat here for discharge.
When your child returns home, it may take up to 6 weeks for the child (and family) to resume normal routines. During the clinic visit and hospital stay, nurses and doctors will give you further instructions on how to care for your child at home.
Please write down any questions you have. Discuss them with your nurses and doctor.
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Important Resources
www.uwhealth.org/kidshearts
Admissions and Insurance Advisors (608) 263-8770
(Financial Counselors) E5/213
AFCH Hospital Information (608) 890-8000
Anesthesia Preoperative Clinic (608) 263-9483
(9:00 a.m. to 5:00 p.m., M-F)
General Billing Office (608) 262-2221
Pediatric Intensive Care Unit (608) 263-8049
Pediatric Cardiology Clinic (608) 263-6420
Pediatric Cardiothoracic Surgery Office (608) 263-0439
Child Life Department (608) 890-7888
Hospital Paging Operator (608) 262-0486
Pastoral Care (608) 263-8574
Patient Information (608) 263-8590
(for room number and location)
Patient Relations Office (608) 263-8009
Patient & Family Learning Center (608) 890-8039
From HWY 12/18, watch for Exit 258 (Midvale Boulevard/Verona Road). Take this exit and turn right (heading north) on Midvale Boulevard. After about 2.5 miles, you will come to a traffic light at University Avenue. Turn right (east) on University and merge into the left lane. About 1 mile later, turn left (heading north) on University Bay Drive. Continue about 100 yards. The parking entrance to the American Family Children’s Hospital will be immediately on your right. (Note: If you pass the Emergency Department entrance, you have gone too far.)
The information provided should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed physician should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Any duplication or distribution of the information contained herein is strictly prohibited.
Last Updated: 08/17/2011
Copyright © 08/17/2011 University of Wisconsin Hospitals and Clinics Authority. All rights reserved. Produced by the Department of Nursing. UWH #5446
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