Getting ready for surgery

Checklist: leading up to surgery

• Arrange for language interpretation services through your surgeon’s office, if needed.
• Ask your surgeon if you will need a special car seat (for example, children having orthopedic surgery sometimes need one).
• Ask your surgeon if you will need any special equipment at home to care for your child or youth.
• Make sure your child does not take ibuprofen or anti-inflammatory medications for one week before surgery. Do not give:
  • Advil® or Motrin®
  • Aspirin®, Aleve® (ASA) or Pepto-Bismal® Naprosyn®
  • Gingko
  • St. John’s Wort

Make a note of the following:

Name of surgery:
Name of surgeon:
Surgeon’s office phone number:
Pre-anesthesia clinic (C3) appointment, date and time:
Date of surgery:
(The admitting team will call you 1 - 2 days before your surgery and tell you when to arrive at the hospital)
Time to arrive:   

If you know what to expect, you will be better able to help your child or youth:

• Ask your doctor for resources to read.
• Ask staff at CHEO’s Kaitlin Atkinson Family Resource Library to help you find information. Call 613-738-3942.

Giving consent for a surgery or procedure

Only the patient or a legal guardian can sign the consent form. You must bring legal guardianship papers if you are not the child’s or youth’s legal parent.

It’s important that you understand the risks and benefits of the surgery, so that you can give an informed consent.

Before you sign the consent for surgery, make sure you understand:

• what the surgery is    
• why it is needed
• why it will help your child or youth (benefits)
• what problems could happen (risks)
• any other ways to treat the problem

Your surgeon may ask you to provide written consent during a clinic visit. If not, you will be required to give consent on the day of the surgery or procedure.

During surgery, your child or youth will have medications to keep them comfortable. This is called anesthesia. It can involve many levels of sedation from numbing the area to a deep sleep (general anesthesia).

Risks and side effects

Use of anesthesia in children is common, but may have side effects. These side effects depend on your child’s or youth’s medical condition and history. A recent cough or cold can increase the risks of anesthesia. See the section called “What if my child or youth is sick before surgery?”

It’s important to prepare children and youth for the anesthetic. Explain to your child or youth that they will:

• get medicine to help them feel comfortable and sleep before the surgery and during surgery
• breathe the medicine in through a mask or get it through an IV (a soft tube placed in a vein in the hand or arm)
• have an IV, no matter how the anesthetic is started. A numbing cream/spray is often applied to the site before insertion of the IV if it is placed while awake
• receive additional oxygen or gas through a mask or small breathing tube
• will be taken care of the whole time by the anesthesiologist

Your child or youth may need to see an anesthesiologist or nurse practitioner in the pre-anesthesia clinic. This will depend on the medical history of your child or youth and the surgery or procedure they are having.

A nurse or nurse practitioner may do an assessment over the phone. This will be decided by your surgeon. If you don’t require a pre- anesthesia clinic visit, you will be assessed on the day of surgery. If you live a far distance from the hospital, we can sometimes arrange an appointment with the anesthesiologist through videoconferencing.

If you need to see the anesthesiologist or nurse practitioner, you’ll have an appointment in the pre-anesthesia clinic about two weeks before the surgery. You’ll find the clinic at C3, on Level 2 of CHEO. Please register at the desk when you arrive. We offer services in French and English. We have translation services available if you speak another language, but your doctor’s office will need to call us ahead of time to make these arrangements.

Anesthesiologist: A doctor who specializes in giving patients medicine to go to sleep and stay asleep during surgery. They help control pain and manage vital body functions during surgery

What you need to bring to the clinic:

• your child’s or youth’s most recent health card    
• proof of your address (like a driver’s licence)    
• medical insurance information (if needed)
• your child’s or youth’s immunization record
• a list of medications, homeopathic or herbal remedies and dietary supplements your child is taking

What will happen during the appointment?

You will first meet the nurse, followed by the anesthesiologist or nurse practitioner. They will:

• ask questions about your child’s or youth’s health    
• measure their weight and height
• check their heart rate, blood pressure and oxygen level
• let you know what to expect on the day of the procedure or surgery

The doctor you meet in the pre-anesthesia clinic may not be the anesthesiologist on the day of the surgery. The doctors may decide your child or youth needs investigations (e.g. blood tests or X-rays) before surgery. If your child or youth needs these tests, your visit to CHEO will be longer.

Having surgery can be stressful for your child or youth and their whole family. Knowing what to expect on the day of surgery will help everyone to be better prepared. Make sure to:

• Tell the truth about what will happen — this helps your child or youth trust you and CHEO staff. The truth is often less scary than what children are thinking.
• Ask questions and have your child or youth tell you what they know. This is a good way to find out what they are thinking, so you can correct any misunderstandings.
• Avoid bribes or threats.
• Reassure them that it is OK to feel nervous or scared.
• Give your child or youth some control by giving age-appropriate choices: “Which toy/activity would you like to bring?”