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Our Preoperative Program – The first step
Hasbro Children’s
Hospital  Preoperative teaching
program (POP) is an educational and interactive program to familiarize
you and your child with the surgical experience. It gives each
child and parent (or special adult) an opportunity to meet operating
room staff and become comfortable with the environment.
The program takes
place Monday through Friday at 2 p.m. Your child’s appointment
will be listed on the front of the booklet you’ll receive.
If your child has special needs – such as hearing, educational
or mobility – please inform us ahead of time so that we
may help your child participate completely in the program. Also,
if your child has been exposed to a contagious illness (such
as chicken pox, TB, fifth disease, etc.) within the last 21 days,
please notify us at (401) 444-6088.
On your scheduled
POP day, please report to the surgical
services, suite 211, on the second floor of HCH, at 2 p.m. Please bring
the following to POP:
- Written list
of questions and concerns
- Parking ticket
for validation
- Blood work results
(if done at an outside lab)
- A complete immunization
sheet
Cancellations
Weather conditions
may occasionally lead to cancellation of POP. When in doubt,
call (401) 444-6088, listen to WPRO-630 AM , or WJAR Channel 10
news or look up the storm report on oso.com, for information.
Your child’s medical history is
considered
 During POP your anesthesiologist
will ask your child’s medical history. It is important to
know if your child has a chronic medical condition or is on any
prescribed medications.
If your child’s
medical condition is complicated, ask your pediatrician to supply
a letter explaining any particular problems. Specifically ask
if your child has a heart murmur. Most children with heart murmurs
are at no additional risk from anesthesia, but information from
your pediatrician may be important.
Lab testing
Under certain
circumstances, lab testing, including blood count and urinalysis,
may no longer be necessary prior to surgery. Need will be determined
by the surgeon and anesthesiologist according to specific guidelines.
Some children may require a type and crossmatch. If your doctor
determines that your child does, please bring your yellow card
from transfusion services.
Parents are an important part of our team
The operating
room staff appreciates the important role you play in the care
of your child. We have developed a program in which you may be
able to stay with your child until he or she falls asleep. You
will have an opportunity to discuss this further with an anesthesiologist
at the POP program.
Be honest with your child
The most important
thing you can do to help your child is to be honest when you
talk about the hospital experience. For example, preoperative
blood tests hurt, so don’t tell a child that a needle is
painless or feels like a "tiny mosquito bite." We have
found that kids who know what to expect are less fearful and
have a far better experience than other children.
Preparation the night before surgery
Going for a number
of hours without eating or drinking is often difficult, especially
for children. Fortunately, recent research has demonstrated that
clear fluids can be safely given up to two hours before an operation.
NPO guidelines
Here are the guidelines:
- No solids, milk products,
candy, or gum after midnight the night before surgery.
- Clear fluids may be given
up until two hours prior to surgery (clear fluids include water,
Pedialyte®, ginger-ale, apple juice, Jello® and popsicles
without fruit pieces, clear broth, and Kool-Aid®).
- Breast milk is permitted
up to 4 hours prior to surgery, but no whole milk of any kind.
- Formula is permitted up
to 6 hours before surgery.
A simple cold may not cancel surgery
A child who has
symptoms such as nasal congestion, sneezing and even a dry cough
may be safely anesthetized in nearly all cases. However, the
final decision lies with the anesthesiologist, who will take
into account the child’s age, medical history, and the planned
procedure.
If you have doubts,
or symptoms change, please call (401) 444-6088 and speak to one
o f our pediatric staff. Keep in mind that a child who is too
sick to go to school is likely to benefit from a one- to two-week
delay for an elective operation.
The day of surgery
On the day of
your child’s surgery, please report to the surgical services desk (suite 210), second floor
of Hasbro Children’s Hospital. Your actual surgical time is typically
one hour after your arrival time. Soon after you have arrived,
your child will be given pajamas and you and your child will
be escorted to our surgical holding rooms which are equipped
with videocassettes, video games, toys, a television and other
diversions.
Although we recommend
that valuables be left home, lockers are available for your use.
You are encouraged to bring special items from home which will
make your child feel secure, such as a special blanket or stuffed
animal.
If your child
has been exposed to communicable diseases, such as chicken pox,
please notify us. And, remember, we are always happy to answer
any questions, so please call (401) 444-6088 (if no one is immediately
available, you may leave a message and your call will be returned
promptly).
Caring for your child as a team
 In
addition to your child’s surgeon there is a team of dedicated
professionals who will care for your child. Our staff includes
anesthesiologists with additional expertise in pediatrics. Anesthesiologists
are physicians specially trained to make certain that your child
feels no pain during the surgical procedure and to closely monitor
all vital functions during surgery and recovery. You will have
an opportunity to speak with an anesthesiologist at POP and again
on the day of surgery.
The team also
includes an excellent group of nurse anesthetists, operating
room and recovery room nurses, and a child life specialist who
are skilled in the care of children.
Your child is in good hands
Virtually all
children undergoing surgery receive general anesthesia. This
means that they will sleep very deeply during the operation.
They will not awaken during surgery or have bad dreams, a common
fear of even small children.
Most children
like to avoid needles, so we usually begin anesthesia with a
 breathing
mask. After the child is asleep, an intravenous needle (IV) is
inserted to give fluids and any additional drugs. However, some
children are afraid of the mask on their face and prefer the
IV first. And that’s okay too. In our experienced hands,
each of these techniques is equally safe.
To maintain your
child asleep, we typically provide a combination of inhaled gas
and intravenous medications. The amount used depends on the patient’s
approximate weight. While the child is asleep, local anesthetics
may be injected near the surgical site. This allows for a less
painful recovery period after the child awakes.
The risks of
anesthesia vary little with the technique that is used. The likelihood
of encountering serious complications during routine surgery
is extremely low. Children may have minor discomforts, such as
a sore throat and nausea.
Parent and child are reunited in recovery
After the surgical
procedure is complete, your child will be taken to the recovery
room. Most children benefit from having family close by during
recovery. The recovery room nurse will require a few minutes
to settle your child and will then invite you to join your child
in recovery.
If your child
is being discharged on the same day of surgery, we recommend
that two adults accompany the child home from the hospital.
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University Surgical Associates