Your Child's First Day Surgery or Outpatient Surgery at American Family Children's Hospital
Date of Surgery: ________________
Your Child’s Surgery: __________________
On the 3rd level
Parking in the visitor's ramp is free for the day of surgery.
Please arrive by your scheduled time.
- Park in the AFCH Ramp
- 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.
- 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.
Before your child’s clinic visit, please
Welcome to the American Family Children’s Hospital
Knowing what to expect is an important part of getting ready for surgery. We will help you and your child through each step of surgery and recovery. The family is part of the team helping your child. One of the best ways to help prepare your child is to explain what will happen before the day of surgery. Please ask any questions that you may have during the time that you are with us.
If you are unsure about what to tell your child or if your child has fears, nursing and child life specialists can help you. They can be reached through the Child Life Office at (608) 890-7888.
Your Child’s Pre-Surgery Clinic Visit
Members of the surgery team will meet with you and your child. You can expect to:
- Learn more about what to expect before, during, and after surgery.
- Answer questions about your child’s health history.
- Have a physical exam, unless it was done by your child’s own doctor.
- Complete any tests that are needed.
- Get answers for any questions you may have.
This clinic visit may take 1 – 4 hours or more to complete.
You will be asked to sign a consent form showing that you understand and wish your child to have the operation. You may also meet with the anesthesia staff.
You will be given the approximate time for your child’s surgery the day before surgery (or on Friday before a Monday surgery). A nurse will call you at your home or place of work to tell you when to arrive at the American Family Children’s Hospital Surgical Services Unit. The nurse will also answer any questions that you may have. If you do not hear from us by 2:00 pm, please call (608) 890-6900 to ask about your time.
If your child has been exposed to chicken pox, or has a cold, fever, or other illness the day before surgery, please call your surgeon’s office between 8 a.m. and 4:30 p.m., Monday through Friday. After hours, nights, weekends, and holidays, please call (608) 262-0486. This will give you the paging operator. Ask for the pediatric anesthesiologist on call. If you live out of the area, please call 1-800-323-8942.
Steps for Getting Ready
- If your child takes medicines that contain aspirin or ibuprofen (Advil®, Pediaprofen®, Children’s Motrin®) or blood thinners (Coumadin®, warfarin), please check with the surgeon at the clinic visit as to whether these should be taken before surgery. Some of these medicines may need to be stopped 7 to 14 days before surgery. Omega 3 supplements may also need to be stopped before surgery. Acetaminophen (Tylenol®) may be used if needed for pain or fever.
- Your child will need to stop eating solid foods and milk at midnight the night before surgery. Four (4) hours before surgery, your child will need to stop drinking clear liquids (apple juice, water). This will help prevent stomach contents from getting into your child’s lungs. If you are breastfeeding, the last feeding should be finished 4 hours before surgery. Formula fed babies should complete their last feeding 6 hours before surgery.
- The night before, your child should bathe or shower. The nurse will let you know if you need any special soap. Wash your child’s hair with the normal shampoo.
- The morning of surgery, your child may brush his teeth and rinse, but should not swallow. If your child is young, you may want to skip brushing in the morning so he does not swallow any water.
- You will be told if your child should take any morning medicines with a sip of water.
- Please remove all make-up and fingernail polish.
- Please leave all jewelry at home.
- If you are coming from out of town, you may wish to stay in Madison. A Housing Coordinator, (608) 263-0315, can provide you with a list of nearby motels and arrange for your stay at a discount rate. A Ronald McDonald House, a place for parents and families to stay, is just a few blocks from the hospital.
- We will have a gown for your child to wear, but in some cases the child’s own pajamas may be worn. Short-sleeved or button-down tops are preferred. Pajamas with feet may not be worn in the operating room. Bring your child’s socks or slippers to wear before and after surgery.
- Plan to bring a special toy, blanket, book, or video to comfort or entertain your child. Your child’s name should be on all items.
- Bring along any of your child’s nebulizers, inhalers, hearing aids, or other special equipment that your child may need. Be sure these items are labeled.
- If your child wears contacts, do not wear them to the hospital. Please have your child wear glasses instead, and bring a labeled case.
- Please try to leave other children at home. It may be hard to care for your child with other children present. You may wish to bring something to read or do while waiting.
- When your child returns home, it may take a few days or weeks for him to resume normal activities (school, daycare). You will want to plan ahead for the time it takes your child to get better. The length of time will depend on the type of surgery done. During your child’s clinic visit, nurses and doctors will talk with you about how to take care of your child at home. Keep in mind that even minor procedures are still surgery. Your child should plan to take it easy for a while.
The Day of Surgery
On the day of surgery, check in at your scheduled time at the reception desk on the 3rd floor of AFCH. You will be checked into a private room where a nurse will ask you questions. Anesthesia staff will see you and your child. Liquid medicine may be given to help your child relax. Most children will have an intravenous (IV) tube started. Younger children have the IV started after they are asleep.
In the Operating Room
One parent may be allowed to go into the operating room (OR) and stay until the child is asleep. Parents of very young infants will be asked to wait in their child’s room. The anesthesiologist will discus this with you on a case by case basis.
The OR 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.
While in the OR, you may see staff wearing masks, gloves, and goggles.
The amount of time your child spends in the OR depends on what is being done. Your nurse will give you specific instruction on where to wait depending on the estimated length of your child’s surgery. You will have a pager if you wish to leave the area. This allows us to page you back when the surgeon is ready to talk with you.
For longer surgeries, we will give you an update about every 2 hours as well as when it is ending.
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.
You will be able to go to the recovery room once your child is settled. Nurses will check your child’s blood pressure, pulse, and incision. This may be done often depending on the type of surgery your child had. You may notice beeps and sounds from machines used in the room.
In the first half hour after waking up from surgery your child may appear very unhappy and crabby. Children often wake up from anesthesia quite confused and very agitated. This agitation is not necessarily related to the amount of pain they feel. When your child becomes more awake this will slowly improve.
Dealing with Pain
Our goal is to help your child have as little pain as possible. Even so, your child may have some pain. The steps below 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 decrease your child’s pain.
- Talk with your child about how to describe and rate pain.
- Older children may be able to use a number rating scale (0 means No Pain and 10 means The Worst Pain).
- Younger children can be taught to use the pain face scale below (the face above 0 means no pain; the face above 5 means the worst hurt you could imagine).
- Help the nurses and doctors assess your child’s pain, and let them know what helps to make your child feel better.
- Pain medicine may cause your child to feel drowsy or lightheaded. If old enough, do NOT allow your child to drive, drink alcohol, or do jobs that require alertness.
Your child’s surgery is scheduled as Outpatient Surgery. You will be able to take your child home the same day. When your child is ready, a nurse will take you and your child back to the room in the Pre/Postoperative area. Nursing staff will keep checking on your child. Our goal is to make sure your child is as comfortable as possible after the surgery. The length of your child’s recovery time before going home varies.
First Day Surgery
Your child’s surgery is scheduled as First Day Surgery. Your child will be staying in the hospital after surgery.
Depending on the type of surgery, your child may have
- An IV (intravenous tube) is placed in a vein to provide fluids and medicine until your child is able to drink fluids well.
- A face mask or tube under your child’s nose to supply oxygen.
- A monitor to record heart rate and breathing.
- A catheter to drain urine from the bladder. Your child may have the urge to urinate even though the bladder is empty.
- An NG (nasogastric) tube through your child’s nose into the stomach to help prevent nausea and vomiting.
- Wound drains to help the incision heal.
You and your child will be taken to one of the inpatient floors when your child is ready to leave the recovery room. Once your child is settled into one of the private rooms, nursing staff will check on your child often. Each room has a bathroom and a sleep chair for one parent. In the Pediatric Intensive Care Unit (PICU), a sleeping room may be provided for both parents.
Your child may not be able to eat right away since eating can cause nausea or vomiting. Depending on the surgery your child had and how well your child is able to take fluids, your child’s diet will change from clear liquids (Pedialyte®, juice, or gelatin) to full liquids (formula, milk, or ice cream) to solid foods.
Your child will be asked to take deep breaths. The nurse will help you hold your young child if needed. As soon as the doctor allows, your child will be able to slowly resume normal routines. For those children who can not walk, strollers, wagons, and wheel chairs will be used. When able, your child may take part in the playroom or schoolroom.
If your child has outpatient surgery, we make every effort to send your child home on the same day. There is always a chance your child will need a short hospital stay. If we have any concerns, we will have your child stay until he is well enough to go home. Parents may stay overnight if this should happen.
If your child has First Day Surgery, the length of the stay in the hospital depends on the type of surgery. Before leaving, we will talk with you about how to care for your child at home. You will receive prescriptions for any medicines your child will need which can be filled here, at your HMO pharmacy, or at a place of your choice. Please bring your insurance card.
You may want to have someone else drive so that you can take care of your child on the way home. Please bring your child’s car seat for the ride home.
List any questions you may have
Important Phone Numbers
If you have questions about surgery or any other service, please call.
AFCH General Information (608) 890-8000
AFCH Surgical Services Unit (608) 890-6900
Hospital Paging Operator (608) 262-0486
Admissions and Insurance Advisors (608) 263-8770
(Financial Counselors) E5/213
Anesthesia Screening Clinic (608) 263-9483
(9:00 am to 5:00 pm Monday-Friday)
Billing office (608) 262-2221
Child Life Specialist (608) 890-7888
Family Resource Center (608) 890-8040
Patient & Family Learning Center (608) 890-8039
and Ronald MacDonald House (608) 890-8000
Pastoral Care (608) 263-8770
Patient Relations Office (608) 263-8009
The Spanish version of this booklet is HFFY #5673
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: 10/10/2013
Copyright © 10/28/2011 University of Wisconsin Hospitals and Clinics Authority. All rights reserved. Produced by the Department of Nursing. HF#4292
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