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Surgery

Day of surgery

Accompanying your child
Spread of infections
Surgery cancellations
Day Surgery Unit
During surgery
What if my child becomes upset?
Child life specialist
Checklist


Accompanying your child

Who should come to CHEO?

Just 2 adults can come along with a child having surgery at CHEO. Please make sure to arrange child care for your other children. Do not bring them to CHEO with you. Grandparents, uncles and aunts should also stay at home. At least 1 parent must stay at CHEO during the surgery.

Going to the operating room

You can walk with your child or teen to the operating room. Your child may walk, be carried or lie on a stretcher. Your child can bring a special soft toy or blanket for comfort. Please have slippers or clean shoes for your child or teen to wear into the operating room. Outdoor shoes are not allowed in the operating room. Different members of the health care team will ask you about the reason for your child’s surgery. This ensures that all members of the team have the same important information about your child’s surgery. In many cases, the surgeon will use a marker to mark the site of your child’s surgery.

Parental Presence at Induction (PPI)

We understand that surgery can be a stressful experience for families. The PPI program allows one parent or other support person to stay with a child or teen for the start (induction) of anesthesia. The anesthesiologist will decide if PPI is right for you, your child and the surgical team.

If you want to take part in PPI:

  • Your child must be at least one year old
  • Your child must be medically stable
  • Your child must not have complex medical needs
  • The surgery must be scheduled ahead of time (no emergency surgeries)
  • A staff person must be available to stay with you
  • You must be willing to leave the OR as soon as the anesthesiologist asks you.

Please ask your nurse, anesthesiologist or Child Life Specialist about PPI.

In the operating room, you will help the most when you:

  • Allow your child or teen to go to the OR on her own if she wants
  • Hold your child’s hand gently
  • Sing or speak in a soothing, quiet voice
  • Distract your child or teen by talking about something other than what is happening at the moment.

As children and youth become sleepy from anesthesia, some close their eyes and fall asleep smoothly. Others enter a stage of excitement. During this stage, they may move their arms or legs. Some may seem dizzy, with noisy breathing or coughing. You may notice their eyes roll back. All of this is very normal. Your child or teen will not remember this stage.

Preventing the spread of infections

 

We want to make sure our patients get well quickly. Please help us prevent the spread of infections by:

  • Staying home if you are sick (a fever, cough, runny nose, sore throat, diarrhea, a new rash or are feeling ill).
  • Cleaning your hands often with soap and water or alcohol-based hand gel. You must wash with soap and water if you can see dirt or if there is mucous on your hands.

Surgery cancellations or delays

Your time is important, however, surgeries are sometimes delayed or cancelled because:

  • We need to do emergency surgery on a seriously ill or injured child.
  • Another child’s surgery takes longer than expected.
  • We may not have an inpatient bed available for children or youth needing to stay in hospital after surgery (caused by high numbers of patients in our inpatient units).

We will do our best to keep you informed about any delays. We only cancel surgeries if we have no other choice. If your child’s surgery gets cancelled, we will book a new surgery date as quickly as possible.

We appreciate your understanding!

In the Day Surgery Unit

You can find the Day Surgery Unit, on the 3rd floor of the main CHEO building.

Please arrive 2 hours before your child’s surgery time. Arriving early is important so that:

  • We will have plenty of time to get your child ready
  • You will have a chance to talk with the surgical team
  • Your child or teen will not feel rushed.

 In the Day Surgery Unit, you will:

  • Meet and register with a patient service clerk
  • Provide your child’s health card
  • Confirm information about your child
  • Receive an ID badge to wear for the day to identify you as your child’s parent or caregiver.

Nurses:

  • Will give your child or teen a check up and ask about earlier experiences with hospitals and surgery
  • May apply an anesthetic on to the skin to numb the area for the IV
  • Will give your child hospital pajamas to wear
  • Will show you to the playroom, where your child can play before surgery
  • May give your child medication before the anesthesia if the anesthesiologist has ordered it. If we give your child a sedative before surgery, she will rest in bed until surgery. The sedative quickly makes children and youth drowsy.

Keeping Health Information Private

At the registration desk, our clerk will ask parents questions about their children’s health and surgery. Parents may feel uncomfortable answering these questions if others are standing close enough to hear. Please give other families enough space for a private conversation with the registration clerk.

Be kind...

Please don’t eat or drink in front of those who can’t! While you are waiting for surgery with your child or teen, please don’t eat or drink. This is hard for our patients who can’t eat or drink before surgery. If you bring a lunch with you, keep it in a bag and you can eat after your child or teen goes in for surgery. We have lockers in the unit for your coats and your child’s clothing. These lockers don’t have locks, so don’t leave anything valuable inside. You are responsible for your belongings.

What if my child gets really upset?

It’s normal for a child to become upset on the day of surgery. You can help your child by:

  • Being honest. In a calm, quiet way, explain again why the surgery is needed.
  • Not making promises you can’t keep. For example, don’t tell your child that we won’t give them a needle.
  • Reminding your child that you will stay close by.
  • Explaining what will happen next and reassure your child that you’ve been honest with him.
  • Helping your child use distraction or another coping technique like deep breathing.

Child Life Specialist

You may meet a Child Life Specialist on the day of surgery, who can help explain what it’s like to have an operation. Children and youth often have many questions about what will happen to them on the day of surgery.

Child Life Specialists:

  • Develop ways for children and youth to cope with fear and anxiety.
  • Help prepare children and youth for tests and procedures.
  • Enhance patient’s emotional, social and intellectual growth during the hospital stay.
  • Consider each child’s stage of development, family and culture when providing care.
  • Offer chances for therapeutic play and organize playroom programs.

If you have any questions or concerns about preparing your child or teen for surgery, please contact the Child Life Specialist at 613-737-7600, extension 3077.

Volunteers (under the direction of Child Life Services) help support play activities in the playroom. Toys and activities help to pass the time and help children to feel more relaxed. Children often express their feelings best through play.

During surgery

Please wait in the:

  • Day surgery waiting room 3rd floor (room 3108 B, just in front of the elevators). This is where the surgeon will look for you when the surgery is over. Nurses from the PACU (Post-anesthetic care unit) will look here for you to re-unite you with your child or teen.

The waiting room is a good place to think about any questions you’d like to ask the surgeon when the surgery is over. You can eat, drink and use your cell phone in the waiting room.

If time allows during your child’s surgery, you can visit:

  • Oasis Coffee Shop on the 2nd (main) floor, across from the Admitting Department (open from 7:30 a.m. to 11:00 p.m.)
  • The Gift Shop on the second floor, near the front entrance
  • Cafeteria on the first floor (open from 6:30 a.m. to 2:00 p.m.)

Your child’s anesthesia

During surgery, your child or teen will have medication to keep her in a deep sleep. This is called anesthesia. During surgery, the anesthesiologist is the doctor who takes care of your child’s:

  • Anesthesia
  • Pain control IV (intravenous)
  • Breathing
  • Blood pressure
  • Temperature                                             
  • Oxygen levels
  • Heart rate

Many children and youth go to sleep by breathing anesthetic gas through a mask. Some will get medications through an IV. All patients having surgery will have an IV, no matter how the anesthetic is started. Your anesthesiologist will decide the safest way for your child or teen to go off to sleep.

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