Remember-Do not eat on surgery day!Fasting guidelinespages 12 & 13

Form # P5619E November 201329

401 Smyth Road Ottawa, ON K1H 8L1

Tel: (613) 737-7600 Fax: (613) 738-4288 @CHEOHospital CHEOkids CHEO videos

www.cheo.on.ca

Surgery at CHEO

We help children and families be their healthiest

To prevent your child’s surgery from being cancelled, do not let your child eat or drink on the day of surgery. Please follow the fasting guidelines on pages12 & 13 carefully.

You’ll need to bring a valid health card with you. The surgery may be delayed or cancelled if you don’t bring a valid health card.

Do not bring food or drinks into the Daycare Surgery Unit. Please see page 17.

Just 2 adults are allowed to be with your child on the day of surgery (at least 1 parent or guardian). Brothers, sisters, grandparents, aunts, uncles or friends must stay at home. Please see page 16.

Bring this booklet with you on the day of surgery.

Notesthings to remember theday of surgery:

o Arrange for language interpretation services through your surgeon’s office if needed.

o Ask your surgeon if you will need any special equipment at home to care for your child.

o Ask your surgeon if you will need a special car seat (for example, for children having orthopedic surgery).

Getting ready for surgery at CHEO (a nurse will complete some of the following on the day of surgery)

Name of surgery: _____________________________________ Name of surgeon: ____________________________________ Surgeon’s Office Phone Number: ________________________

Pre-assessment clinic (C3) appointment date:_______ time: _______

Date of surgery: ____________________________________ Time of surgery: ____________________________________ Expected stay in Post-Anesthetic Care Unit: _______________

Return to Day Care Surgery: ___________________________ Expected discharge: ___________________________________ Expected time to hospital room: ________________________ Please arrive at the Day Surgery Unit, 3rd floor, 2 hoursbefore your child’s surgery time. Your doctor will tell you ahead of time if your child needs to be admitted to CHEO the day before surgery.

Contact Numbers:CHEO’s main phone number 613-737-7600

CHEO Day Surgery Unit Monday-Friday 6:30 a.m.-7:00 p.m.613-737-7600 ext. 2347 or 2346 Admitting 613-737-7600 ext. 2310

Pre-assessment Clinic 613-737-7600 ext. 2522

Child Life Specialist 613-737-7600 ext. 3077

Parent and Family Representative613-737-7600 ext. 2203

Ronald McDonald House 613-737-5523

Kaitlin Atkinson Family Resource Library 613-738-3942 library@cheo.on.ca

Rotel 613-733-1412 toll free 1-800-267-4700 www.rotel.ca

Websites:CHEO’s Surgery Virtual Tourwww.cheo.on.ca/virtual_tour/index.html

Society of Pediatric Anesthesiawww.pedsanesthesia.org/patiented/faq.iphtml

Children’s Hospital of Philadelphia - What it’s like to have anOperation (ages 6-12)www.chop.edu/kidsheathgalaxy/index.html

Canadian Anesthesiologists’ Society (patient infomation)www.cas.ca/English/Patient-Information

MindMasters www.child-youth-health.net/en/child-youth-health/MindMasters_p280.html

Resources Checklist: Leading Up to Surgery

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Welcome to CHEO ............................................................1Parking...................................................................2Maps of CHEO ................................................................2-3Resources and phone numbers............................................ 26

Getting Ready for Surgery pages 4 - 10 Getting Ready for Surgery .................................................4 Giving consent ..............................................................5 Talking about anesthesia ...................................................6 Tools to help children cope.................................................9 Just for teens ..............................................................10 The Day Before Surgery pages 11 - 13 Checklist: Day before surgery ... .................................... 11 Fasting Guidelines .................................................12-13 Confirming Surgery ...................................................14

The day of Surgery pages 15-22 Checklist: What to Bring to CHEO.....................................15 Who should come to CHEO .............................................. 16 Preventing the spread of infections ................................. 16 Cancellations and delays ............................................. 16 In the Day Surgery Unit ............................................... 17 What if my child gets really upset? .................................. 18 Child Life Specialist .................................................... 18 Going to the Operating room ......................................... 19 Your child’s anesthesia ............................................... 19 Parental Presence at Induction (PPI) ................................ 20 During surgery .......................................................... 21

After Surgery pages 22-26 Post anesthetic care unit (PACU) ..................................... 22 Staying overnight ....................................................... 23 Going home ............................................................. 25

We understand that surgery can be stressful for you and your child or teen. We are here to give you the best of care before, during and after surgery. This booklet will help you to get ready, and we hope it will answer many of the questions you may have.

Going Home...

If your child has had day surgery, the nurse will tell you when it’s OK to go home. Your surgeon or nurse will go over any instructions,prescriptions and follow up appointments with you before you leave.

If you don’t have a car, try to ask someone you know to drive you home, or plan to take a taxi. Taking your child home on the bus after surgery is not allowed. Keep a towel or small pail in the car, some children throw up in the car on the way home. Teens are not allowed to drive for 24 hours after having an anesthetic.

Make sure you or another responsible adult stays with your child or teen for 24 hours after the surgery. It is important to watch for any problems that could happen after surgery. Don’t plan any activities for the rest of the day, let your child or teen rest.

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CHEO’s Address:401 Smyth Road, Ottawa, ON K1H 8L1

Welcome to CHEO! We’ve created this booklet to help your family prepare for surgery and navigate through our Pre-Assessment Clinic, Day Care Surgery, Operating Room and Recovery Room. We will provide your child or teen with high quality, family centred care, and this means keeping you involved and informed.

At CHEO, we are always working to improve the quality of our care. In recent years, we have introduced new programs suggested by families, like:• Parental Presence at Induction (staying with your child until he is

asleep from the anesthetic) • Parental Presence in Recovery Room• On line Virtual Tour

We hope you’ll let us know if this booklet has been helpful to you and if you have suggestions for how to make it better.

This is the first step in your surgical journey here at CHEO. We want toassure you that we are here with you every step of the way.

-The Perioperative Executive Team

Not from Ottawa?If your child or teen will be staying overnight at CHEO, other family members can stay close by in one of the reasonably priced places on the CHEO campus. Make sure to call early to reserve a room.

Manoir Ronald McDonald House of Ottawa and Eastern OntarioServes as a ‘home away from home’ offering fully equipped rooms reserved for families with children suffering from cancer or other serious illnesses. Your social worker, nurse or other health care team member must refer you. 613-737-5523

Rotel www.rotel.ca411 Smyth Rd. Ottawa, ON 613-733-1412 or toll free 1-800-267-4700Offers accomodation for any family and friends of CHEO patients.

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CHEO has one visitor’s parking lot, ‘A’, beside the Gary Cardiff Wing and the Emergency Department. This lot can become full, especially between 10 am and noon. Please give yourself enough time to find a parking spot before your appointment at CHEO.

Visitor parking costs $3.50 for each half hour, up to a 24 hour maximum of $13.00. We offer weekly and monthly passes for frequent visitors, and you can purchase these in our Security Department on level 2.

To pay for parking, you can use cash or credit cards at one of our three automated parking pay machines. You can also pay at the exit gate (credit card only). Please bring your parking ticket into the hospital with you if you wish to pay cash.

For more information on parking rates, passes and how to pay, please contact the CHEO Security Department at 613-737-2227 or visit our web page: www.cheo.on.ca/en/parking.

CHEO’s Main Entrance

Back to the Day Surgery UnitAfter waking up from the anesthetic, your child will go back to the Day Surgery Unit to rest. You’ll stay at your child’s bedside until the nurses feel your child is ready to go home. We will encourage most children and teens to have something to drink before going home, and we’ll offer popscicles, apple juice and water. How long your child stays in the Day Surgery Unit after surgery depends on the kind of surgery and how your child feels.

CHEO’s policy does not allow children and youth who have had teeth or implants removed (for example, central lines, screws) to take these items home.

If your child is staying overnight at CHEO...

Your child will go to her hospital room from the PACU. One parent or caregiver can stay overnight-we have bed chairs to sleep in, and we’ll give you sheets, blankets and a pillow.

Visiting GuidelinesParents, caregivers, brothers and sisters can visit anytime (with no more than 2 visitors at one time). Let the Charge Nurse know the names of your immediate family. • Other relatives and friends can visit between 3:00 p.m. and 8:00 p.m. each day, including weekends and holidays.• Sometimes we have to limit visits to parents and caregivers

when a child is in isolation, or when we have many patients with infections in the hospital.

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Getting Ready for Surgery

Operating Rooms

Surgical Waiting Room

A PACU nurse will stay with your child or teen for the entire recovery period, to make sure she is safe and comfortable. It is normal to have some pain after surgery. Each child or teen feels pain differently.

PACU nurses will: • Measure your child’s blood pressure, temperature, oxygen level

and heartbeat regularly• Assess pain and give pain medication if needed• Use comfort measures to ease pain

Please speak with the nurse if you feel your child or teen is in pain.

You can help your child or teen in the PACU by:• Letting your child sleep• Sitting by your child’s side• Comforting your child by: - Speaking in a quiet, soothing voice - Holding his hand or touching him gently - Holding or rocking your child in your arms (check with the nurses first) - Letting your child suck on a pacifier if this is comforting.

Please remember:• We may ask you to leave the PACU for a time in case of a medical

emergency.• Several patients and parents will be in the PACU at the same time.

It is important to respect the privacy of others. No cell phone use or picture taking is allowed.

• Please help prevent the spread of infections to our patients by staying away if you are sick, and washing your hands before you come in and after you leave.

• Food and drinks are not allowed in the PACU.

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Before your child’s surgery, you’ll need to fill out a questionnaire about your child’s medical history. Your child may need to see an anesthesiologist before surgery in the pre-assessement clinic. This will depend on your child’s medical history and the surgery or procedure.

Telephone AssessmentA visit to the pre-assessment clinic isn’t always needed if your child is healthy and having a minor surgery. In this case, a nurse may call you a few weeks ahead of time to:• Review the questionnaire that you completed earlier • Ask about any medications your child is taking• Ask about any allergies• Let you know about what to expect the day of the surgery• Answer any questions you may have

Pre-Assessment ClinicIf you need to see the anesthesia doctor, you’ll have an appointment in the pre-assessment clinic about 2 weeks before the operation. You’ll find the clinic at C3, on the main floor 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.

What you need to bring to the clinic: • Your child’s most recent health card• Proof of your address (like a drivers’ license)• Medical insurance information (if needed)• Your child’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. The nurse will:• Ask you questions about your child’s health• Weigh your child • Check your child’s heart rate, blood pressure and oxygen level• Let you know what to expect on the day of the procedure or operation.

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 may visit the: • 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.)

After Surgery...

Post Anesthetic Care Unit (PACU)Your child or teen will go to the PACU (or recovery room) to fully wake up after surgery. Each patient reacts differently after anesthesia. Some sleep for a long time, while others are restless and cry as they wake up. Your child or teen will stay in the PACU until he is awake, comfortable and stable. This usually takes 30-45 minutes, but it sometimes takes longer. We may be able to bring you into the PACU to see your child. Only one parent or family member can visit in the PACU at a time.

Your child or teen may have:• An IV• Oxygen mask• Monitors for heart rate and blood pressure

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The anesthesia doctor will...• Examine your child and explain what happens in the operating room• Explain how your child will go to sleep and what medications will be used to keep your child comfortable• Discuss whether your child needs medicine to relax before the operation.

The doctor you meet in the Pre-assessment Clinic may not be theanesthesia doctor on the day of the operation.

The doctors may decide your child needs tests like blood tests or x-rays before surgery. We’ll give you the forms for any tests at the time of your visit. If your child needs these tests, your visit to CHEO will be longer. During your visit, a research assistant may speak with you about taking part in research to improve surgical care.

Giving consent for surgery

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, the doctor will explain:• What the surgery is• Why it is needed• Why it will help your child (benefits)• What problems could happen (risks)• About any other ways to treat the problem.

Learning more about your child’s surgery

If you know what to expect, you will be better able to help your child or teen.• Ask your doctor for resources to read• Ask staff at our Family Resource Library to help you find information (see the last page of this booklet).

Parental Presence in the Operating Room (PP)

We understand that surgery can be a stressful experience for families. The PP program allows one parent or other support person to stay witha child or teen for the start of anesthesia. The anesthesiologist will decide if PP is right for you.

To take part in PPI:• Patients must be at least one year old• Patients must be medically stable• Patients must want a parent to be with them• Patients must not have complex medical needs• The surgery must be scheduled ahead of time (no emergency

surgeries)We may not be able to offer this PP option if we do not have a volunteer or Child Life Specialist available. The anesthesiologist has the final decision about whether this program is right for you.

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

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 talk to your child in a soothing, quiet voice;• Try not to ask your child too many questions as he is going to sleep.

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

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• En lui permettant de se faire emmener tout seul à la salle d’opération s’il ou elle le désire;

• En lui tenant doucement la main;• En lui chantant une chanson ou en lui parlant d’une

voix douce et calme;• En n’essayant pas de lui poser trop de questions

pendant qu’il ou elle s’endort.

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Talking about anesthesia (falling asleep for surgery)

It’s important to prepare children and youth for the anesthetic. Explain that your child or teen will:• Get medicine to help her fall into a deep sleep before the 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). We may use numbing cream on the skin before starting an IV.• Be in a special sleep during the surgery, but doctors and nurses

will take care of him the whole time.• Not feel, see or hear anything during the operation.

Talking about surgeryKnowing what to expect on the day of surgery will help your child or teen cope. Make sure to:• Tell the truth about what will happen. This helps your child or

teen trust you and the hospital staff. The truth is often less scary than what children are actually thinking.

• Ask questions and let your child tell you what he knows. This is a good way to find out what he is thinking, so you can correct any

misunderstandings.

These guidelines are based on age, and will help you prepare your child or teen for surgery.

Babies (under 12 months)Your baby will be comforted by familiar objects and people. Bring along comfort items like pacifiers, favourite toys or blankets. After surgery, babies who are not breastfeeding are more likely to drink from a familiar bottle nipple or sippy cup, so bring empty ones with you to use after surgery. Let the surgical team know how your baby may react to being away from you.

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 aspecial 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.

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, theanesthesiologist 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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Talking to Toddlers (1-3 years)Prepare your child the day before surgery with a simple explanation, like, “We are going to the hospital tomorrow so the doctor can fix the bump on your tummy”. Try to give your toddler a little control by of-fering realistic choices: “Which toy would you like to bring?” “Should we bring the blue or the red cup?”

Toddlers may react to changes in their routine. On the day of the surgery, you can help by:• Rocking and holding your child.• Talking calmly and gently.• Distracting your child with toys or books.• Explaining what will happen just a little ahead of

time. (“The nurse is going to take your temperature now, you need to hold very still”).• Explaining that the surgical team is there to help her get better.

Talking to Preschool children (3-6 years)Preschool children may not fully understand why surgery is needed; some children believe they are being punished. You can help by:• Talking about the surgery 2-3 days ahead of time using a calm and

relaxed voice• Talking about the hospital and explaining that it is a safe place and

the staff are there to help• Using play to help your child understand the surgery (toy medical

kits or books)• Avoiding bribes or threats.

For example: “ On Thursday we’ll be going to CHEO to have tiny tubes put in your ears to help prevent all those ear infections you’ve been getting. You’ll get some sleep medicine so you’ll be in a really deep sleep while the doctor puts the tubes in. You’ll wake up in a wake up room where nurses will be there to take care of you. We’ll be able to see you soon after you wake up.”

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What if my child gets really upset?

It’s normal for a child to become upset on the day ofsurgery. 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.

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Talking to School aged children (6-12 years)School aged children have a basic understanding of how theirbodies work. Start preparing your child a week or more ahead of time. They need time to ask questions and talk about their feelings. You can help by:• Encouraging your child to ask questions and express feelings. It’s

OK to feel angry or afraid.• Preparing your child for any stitches or bandages they will see

after the surgery.• Avoiding bribes or threats.

Talking to Youth (12-18 years)Youth are more independent and should become involved in their health care. They may ask for detailed explanations. They are often worried about privacy. You can help by:• Being honest. Your teen has a right to know about everything that

will happen.• Encouraging your teen to ask questions of you or hospital staff. It

may help to write out questions for the doctor or nurse ahead of time.

• Giving space so your teen can speak to the doctor or nurse alone.• Reminding your teen that it’s OK to feel angry or worried.

In the Day Surgery UnitPlease 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.

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

Keeping Health Information PrivateAt 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.

In the Day Surgery Unit, the 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.G

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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 thesurgery.

Preventing the spread of infections

We want to make sure our patients get well quickly. Please help usprevent 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!

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Tools to help children and youth cope with surgery

1. CHEO’s surgery virtual tour Our virtual tour will explain how to get ready, what to expect and will allow your family to see our clinics, operating rooms, and recovery rooms. Visit: http://www.cheo.on.ca/virtual_tour/index.html

2. MindMasters and Mini-MindMasters CHEO’s Partnerships and Advocacy Program has developed these programs to help children master positive living skills. MindMasters was tested at CHEO with children coming for tests and treatments. MindMasters and Mini MindMasters will help you teach your child how to:• Relax• Control stress• Look for the good things in each experience• Think positively• Use positive imagery

Visit: http://www.child-youth-health.net/en/child-youth-health/ Publications_and_Resources_p233.html

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Just for teens...

Getting ReadyYou probably have a lot of questions about your surgery. Make sure you talk with your parents or caregivers and your surgeon so they know what’s on your mind.

If you smoke..Try to stop for at least a week before surgery. Smoking or using drugs or alcohol before your surgery can cause risks that could make your surgery unsafe.

Piercings and jewellery (metal and plastic)Make sure to remove all studs and jewellery before surgery, to prevent problems like:• Choking on or swallowing tongue studs or lip rings. Jewellery in

and around the mouth can become loose or get accidentally pulled out during surgery, and can get stuck in your windpipe or end up in your stomach.

• Piercings getting caught or pulled out when we are positioning you on the operating room bed.

• Burns. Wearing metal jewellery can cause burns if we use certain

equipment during your surgery (like cautery to stop bleeding).

Driving after surgeryYou are not allowed to drive for 24 hours after having an anesthetic.

Teen girls • If you have your period, use a pad instead of a tampon on the day

of surgery.• If there is a chance you may be pregnant, it is very important for

you to tell your nurse or doctor.• Tell your doctor if you use Depo Provera or any other hormonal birth control method.• If you are taking birth control pills, ask your doctor if you should

take one on the day of surgery.• You’ll need to remove your bra when you put on the hospital pajamas- nurses in the operating room will need to place heart monitor stickers on your chest before you fall asleep. We will keep you covered though!

o This booklet!

o Your child’s health card (you will need to pay with a credit card if you do not have the health card with you or if it has expired)

o Legal guardianship papers (if you are not the child’s parent)

o Private insurance information

o A list of your child’s medications and doses

o Comfortable clothes for your child or teen to wear home

o Eye-glasses (make sure your child or teen leaves contact lenses at home)

o Elastics to tie long hair back (metal hair clips are not allowed)

o Slippers or clean indoor shoes

o Bathrobe or zip-up hoodie to wear over hospital pajamas

o A bag for clothing

o Pacifiers and diapers if your child uses them

o Special toy or blanket your child can take into the operating room (we will label this with your child’s name)

o Portable music or DVD players (with ear phones), or hand held electronic games to pass the time (we also have toys and activities in the Day Surgery playroom for children to enjoy while waiting)

o Books or magazines for parents to read

Remember! You are responsible for your child’s valuable items. We do not have locked areas to store them for you.

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Checklist: What to bring on the day of surgery

Make sure your child or teen:

o Follows the fasting guidelines carefully (see page 13-14)o Takes a bath or shower the evening before (or the morning of) surgeryo Removes all make up and nail polisho Removes all jewellery (including plastic jewellery) from piercings (from nose, tongue, belly button, eyebrows, ears...)

Make sure you:

o Help your child pack a bag with comfortable clothes, slippers, music, books and a special comfort toy.o Arrange child care for your other children.o Speak with CHEO staff to confirm the time you should arrive at CHEO.o Arrange for a ride home from the hospital. Patients who have had surgery are not allowed to take public transportation (day surgery only).o Prepare your child or teen so she has an age appropriate understanding of what’s going to happen at the hospital.o Have acetaminophen (Tylenol® or Tempra®) and Gravol® on hand at home.o Remind your daughter to use a pad instead of a tampon on the day of surgery if she is having her period.

Confirming surgery time

We will call you 1-2 days before surgery to confirm what time you should arrive at CHEO. If we do not call you by 8:00 pm the evening before your child’s surgery, please call CHEO’s Admitting Department:613-737-7600, extension 2310, before 11:00 p.m.

What if my child or teen is sick before surgery?Call your surgeon’s office if your child has been in contact with these illnesses in the 3 weeks before surgery:• Measles, Mumps or Chicken Pox• Whooping Cough• Scarlet Fever• TB (tuberculosis)

Contact your surgeon’s office if your child:• Has a cold or cough with mucous (and doesn’t feel like eating or is

very tired)• Is wheezing• Has a fever• Is vomiting or has diarrhea• Has any contagious disease, like ‘pink-eye’, chicken pox, mumps,

measles, tuberculosis (TB), whooping cough or scarlet fever (call your surgeon as soon as possible).

Between 4:00 p.m. and 11:00 p.m. the evening before surgery (or if you can’t reach your surgeon): • Call Admitting 613-737-7600 extension 2310 and tell them your

child or teen is ill.

We will have to cancel surgery and re-schedule it later if your child has any of the illnesses listed above. If your child has mild cold symptoms, but no fever, we may ask you to come to Day Care Surgery in themorning to have your child assessed by the anesthesiologist to decide if we will go ahead with the surgery.

After 11:00 pm the evening before surgery:Call 613-737-2346 (Day Care Surgery) and leave a message. Be sure to include your child’s name, date of surgery, surgeon’s name and theillness (for example, a cold or fever).

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Checklist: The day before surgery

Why can’t my child eat or drink before surgery?Everyone having anesthesia (sleep medicine for surgery) must have an empty stomach. While your child is in this deep sleep for surgery, any food or fluid in the stomach can come back up into the throat, and drain into the windpipe and lungs. This can cause breathing problems and infection, which can be veryserious. Follow fasting directions carefully.

We may need to delay or cancel your child’s surgery if your child has something to eat or drink by mistake.

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Babies and toddlers under 2 years: No food after midnight.

Your child may have: • Formula, milk or fortified breast milk up to 6 hours before

surgery • Breast milk up to 4 hours before surgery • Water, clear diluted apple juice or clear jello gelatin and nothing else up to 3 hours before surgery.

Do not give gum, candies or any fluids with red or purplefood colouring (like red jello or sports drinks).

Children and youth (2 years and older): No food, milk or dairy products after midnight.

Your child or teen may have: • Water, apple juice, ginger ale or jello gelatin and nothing else up to 3 hours before surgery.

Do not give gum, candies or any fluids with redor purple food colouring (like red jello or sports drinks).

Children who are still breastfeeding can have breastmilk upto 4 hours before surgery.

Follow these directions carefully, even if your child has tube feedings.

If your surgeon or anesthesiologist tells you to give your child regular medications the day of surgery, give them with a very small sip of water only. Do not give medications withapplesauce, yoghurt or other foods, even if you usually give medications this way.

Offer your child or teen a healthy snack before bedtime the night before surgery.

Parents and caregivers should not fast with their children. Please eat as you normally would, so you will have the energy you need to support your child.

Some children and youth with on-going health problems may need to fast for 3 hours longer than other children. Your doctor will let you know if this is needed.

If your child is having an endoscopy, please follow the special fasting guidelines that your doctor gives you.!

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