Preparing for Your Child’s Surgery

Thank you for choosing us to take care of your child. Below you will find an outline of what to expect before, during, and after your child’s surgery.

Tips for preparing your child for surgery

• Keep explanations simple, honest, and age-appropriate.

• Encourage your child to be involved. Let your child choose items to bring to the hospital (e.g., things to do, comfort items).

• Have a plan for the return home. Include your child by letting him or her choose a postsurgery treat or activity.

• If you need assistance on how to prepare your child, please contact the Child Life office at (650) 497-8336.

• Only parents or guardians are allowed in the Treatment Center. Please make prior arrangements for supervision of other children.

Before Surgery

Follow the instructions given to you by your provider, including:

• Schedule and complete any tests or office visits the doctor requests.

• Before surgery, you will need to register your child with our hospital. You will get instructions about registration when you schedule your child’s surgery. To preregister by phone, call (650) 497-8229. This service is available 24 hours a day, 7 days a week. You will need to have your child’s insurance information available.

• Have nonspicy, nongreasy foods available at home for after the surgery.

• Please trim your child’s nails to prevent infection and reduce scratching.

• If your child is a girl who is 12 years old or older or has started her period, be prepared to have her provide a urine sample to pre-op when she arrives.

If your child develops a fever, rash, cough, diarrhea, sore throat, skin lesions, or pink eye within 72 hours of scheduled surgery, call your surgeon or PARC:

• Monday through Friday between 9 a.m. and 5 p.m., call (650) 736-7359.

• After 5 p.m. Monday through Friday or on weekends, please call the Operating Room Control Desk at (650) 721-2820.

If you need to cancel your surgery for personal reasons, call the surgery scheduler. If it is the day before, call (650) 736-7359.

Pediatric Anesthesia Resource Center (PARC) phone call appointment

You will receive two phone calls from PARC. About 30 days before your child’s surgery, the surgery scheduler will work with you to schedule the first phone call. The appointment will take place one to three weeks before your child’s surgery. Please provide a current phone number to the scheduler. If possible, please provide a cell phone number so that we can send you a text reminder of the appointment. This call will last approximately 20 to 30 minutes, depending on the complexity of the patient’s history.

Patients who are 18 years old or older will need to provide the information during the PARC call, unless they give verbal permission for a parent to provide the information to a PARC nurse.

The following information will be discussed during the call:

• Your child’s family, medical, surgical, and social history.

• Your child’s diet and any dietary restrictions.

• The current list of medications your child is taking, including the doses.

• A comfort plan for the day of the procedure/surgery, including anesthesia and pain management.

• The discharge plan.

The Night Before Your Procedure/Surgery

Second PARC phone call

The day before your child's surgery, you will receive the second phone call from the Pediatric Anesthesia Resource Center. This call will occur between 1 p.m. and 5 p.m. and usually lasts 5 to 10 minutes. Please have a pen and paper ready to take notes.

The following information will be discussed during the call:

• The time you should arrive at the Treatment Center. Please allow enough time for traffic, parking, and visitor badges. It is very important to arrive on time, or the surgery may have to be rescheduled. Your child’s arrival time is dependent on the age and severity of other patients who are also scheduled that day.

• A brief update on how your child is doing, including any recent fever, cough, cold, etc.

• The eating and drinking instructions specific to your child’s needs, including when to give medications, last time to give foods, and last time to give liquids. This can be written down on the Eating and Drinking Instructions page in this brochure (page 11).

• The address and location of the Treatment Center.

If you have provided your cell phone number, you may receive a text after 6 p.m. with a reminder of your arrival time and the time to stop giving your child food and drink.

Preparing the skin before surgery

A surgical site infection is an infection that occurs in the area where an operation has been performed. There are some things that you can do to lower the risk of your child developing a surgical site infection, such as reducing the bacteria (“germs”) on your child’s skin. Your clinic may give you some special disposable wipes moistened with 2% chlorhexidine gluconate (CHG) antiseptic solution to help prepare your child’s skin for surgery.

Information:

• Please read and follow these instructions for bathing and skin care the night before your child’s surgery.

• You might need a second adult to help you with this process.

• Have clean, freshly washed bed sheets, towels, and pajamas ready to use the evening before surgery.

• Do not shave any part of your child’s body the day before or the day of surgery.

• If you would like to warm the wipes before using, please place the closed packet in a bowl of warm water at bathwater temperature.

Directions:

1. The night before surgery, shower or bathe your child with soap and warm water, and wash his or her hair.

2. Dry your child with a clean towel.

3. Wait at least one hour to let your child completely dry before applying the wipes.

4. Open the package: Using clean scissors, cut off the end seal of the package and throw away the foam piece.

5. For each package, remove two cloths at a time, and place onto a clean surface.

6. Wipe your child’s skin as shown in the pictures on the next page. Use one wipe for each area of the skin as shown by the numbers in the diagram.

7. Avoid contact with eyes, ears, mouth, genitalia, and any cuts or open areas of the skin. But, DO wipe the superficial skin and groin area (the creases where the legs meet the body).

After care:

• Throw the wipes in a trash can.

• After using the wipes, let skin air-dry. Your child’s skin will feel sticky until dry.

• Do not rinse CHG off the skin before surgery.

• Have your child put on clean pajamas and sleep in clean sheets.

• After applying CHG wipes, do not have your child shower, bathe, or apply lotions, moisturizers, or other personal care products.

How to use CHG wipes on your child

For children less than 22 pounds (<10kg)

Use the 1st cloth on your child’s chest, both arms, back, and neck.

Use the 2nd cloth on both legs (back and front), the buttocks, and the groin area.

For children less than 22 pounds (<10kg)

Use cloth on groin area. Do not use on genitals.

For children between 22 and 66 pounds (10–30kg)

Use the 1st cloth on your child’s chest, both arms, and neck.

Use the 2nd cloth on the back and buttocks.

Use the 3rd cloth on both legs (front and back).

Use the 4th cloth on your child’s groin area.Use cloth on groin area

For children between 22 and 66 pounds (10–30kg)

Use cloth on groin area. Do not use on genitals.

For children more than 66 pounds (>30kg)

Use the 1st cloth on your child’s chest, both arms, and neck.

Use the 2nd cloth on the RIGHT leg.

Use the 3rd cloth on the LEFT leg.

Use the 4th cloth on the back.

Use the 5th cloth on the buttocks.

Use the 6th cloth on your child’s groin area.

For children more than 66 pounds (>30kg)

Use cloth on groin area. Do not use on genitals.

Eating and drinking instructions

We have listed our eating or drinking instructions for surgery patients below. These must be strictly followed to keep your child as safe as possible. If these instructions are not followed, your child’s surgery may be delayed or canceled. A small number of children will receive special instructions that are different from these. Follow the instructions that the PARC provider has given you.

1. Stop food and candy at midnight. Food includes anything that’s NOT formula, milk, breast milk, or clear liquids.

2. Stop formula and milk 6 hours before arrival time.

3. Stop breast milk 4 hours before arrival time.

4. Stop all clear liquids 2 hours before arrival time. Clear liquids include only water, clear apple juice (no pulp, no apple cider), Pedialyte, and Gatorade.

5. Continue to take prescribed medications with a small sip of water unless told otherwise to discontinue.

Use cloth on groin area. Do not use on genitals.

EATING AND DRINKING GUIDELINES - for patients coming for a surgery or procedure

We encourage your child to drink clear liquids up until your arrival time. It is important to make sure your child is hydrated and has enough liquids in their body. This will keep them comfortable and help with their recovery after surgery. Clear liquids include only water, Pedialyte, Gatorade, and clear apple juice. The apple juice cannot be cider or have pulp. Have your child drink clear liquids up until the time they are scheduled to arrive at the hospital.

Keep taking prescribed medicines with a small sip of water unless the care team tells you to stop.

STOP food and candy at . . . . . . . . . 12 a.m. (Midnight)

Food includes anything that’s NOT formula, milk, breast milk or clear liquids.

STOP formula and milk at . . . . . . . . .

STOP breast milk at . . . . . . . . .

STOP all clear liquids at . . . . . . . . . Arrival Time

Clear liquids include only water, Pedialyte, Gatorade, and clear apple juice. The apple juice cannot be cider or have pulp.