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Preparing for Surgery

Have a surgery scheduled at Cook Children's Northeast Hospital? The following information for parents, families and patients may be of help.

Before surgery

Please be sure that your insurance company has been notified of the upcoming surgery. This is known as pre-certification. Pre-certification is often required before the insurance company will pay. The doctors' office staff usually contacts insurers, but it is your responsibility to make sure the doctor's staff called for pre-certification.

Payment may be required upon admission. Cook Children's Northeast Hospital accepts MasterCard, Visa, American Express and Discover cards. It is your responsibility to:

  • Contact our hospital to learn how much you must pay for your child's care.
  • Pay Cook Children's for all charges not paid by your insurance company.
  • If you have questions or need information about payment, call 817-605-2852.

Please be prepared to bring the following on the day of your child's surgery:

  • Your current driver's license and insurance card.
  • Legal documents concerning guardianship, if you are not the child's natural parent.
  • A list of your child's current medication, if any.
  • All medical information about your child.
  • Any special information, instructions or paperwork from your doctor, such as doctor's orders or envelopes from the office.

Pre-op tour

Free pre-op tours are offered at Cook Children's Northeast Hospital. The tour will introduce you and your child to hospital staff and explain what to expect on the day of surgery. Please reserve a place for your child and family the week before the scheduled surgery by calling 817-605-2823 between 9 a.m. and 5 p.m. Reservations are necessary.

Talking with your child about surgery

Many families find it difficult to talk with their child about his/her upcoming surgery. We suggest that you give your child honest, age-appropriate information, so he/she won't worry or be surprised. Involve your child in preparations, such as shopping for Popsicles™ or packing a favorite toy to take to the hospital. Using a toy doctor's kit or drawing pictures of the hospital can help your child express thoughts. Reading a book about hospitals (check your local library) can be a good starting point for discussion. Suggested books include:

  • "Why Am I Going to the Hospital?"
    Claire Ciliotta and Carole Livingston
  • "A Big Operation"
    Richard Scarry
  • "Going to the Hospital"
    Fred Rogers
  • "Franklin Goes to the Hospital"
    Paulette Bourgeois and Brenda Clark
  • "KoKo Bear's Big Earache - Preparing Your Child for Ear Tube Surgery"
    Vicki Lansky
  • "Chris Gets Ear Tubes"
    Betty Pace

The night before surgery

It is important that your child get plenty of rest before surgery. Be sure your child bathes and washes his/her hair. This helps us, and helps your child feel better while recovering.

Make sure your child has a well-balanced dinner the night before surgery. Give him/her plenty to eat and drink just before the food and drink cut-off time specified by your doctor. After the cut-off time, do not let your child have anything to eat or drink, not even hard candy, gum, water or ice. It is even best not to brush his/her teeth, as some of the water or toothpaste may accidentally be swallowed.

For your child's safety, it is important that his/her stomach is completely empty prior to being given anesthesia. Serious complications could arise with even small amounts of food or water in the stomach. Since children forget and may help themselves to food, they will need to be closely watched. If your child accidentally eats or drinks anything after the cut-off time, you must notify the nursing staff so that proper precautions can be taken.

On the day of surgery

Sometimes parents are reluctant to eat when a child cannot, but in order to handle the day's activities and attend to your child's needs, you will need energy. We suggest you eat a nutritious meal before waking your child.

Check-in – Go directly to the surgery registration desk for check-in. After your child is registered, you will be taken to the outpatient surgery department.

Your child may or may not be given medication before surgery, depending on his/her individual needs and the procedure involved. After your child is anesthetized, an intravenous line (IV) will be started in most cases, and will remain in place until discharge.

What to bring on the day of surgery

  • A blanket or toy
  • Extra underwear or diapers
  • Comfortable clothes
  • An empty bottle or child cup
  • A pacifier
  • A blanket, towel and a car safety seat (if appropriate) for the car
  • Driver's license or other identification for parent or guardian

What NOT to bring on the day of surgery

  • Children, other than the patient
  • Adults, other than parents or guardians
  • Food or drink, including gum, which the child could eat before surgery

Plan on staying with your child

A parent or adult caretaker must stay at the hospital while surgery is being performed. In addition, parents or guardians must remain in the waiting room at all times during and after surgery. If you must leave this area, even for a minute, please tell the receptionist where you will be.

Children who receive general anesthesia, with or without pre-operative medication, will sleep 60 to 90 minutes after their surgery. However, it is still very important that one parent or guardian remain in the waiting room at all times during and after surgery.

For your convenience

  • Dining and snacks
    Coffee is available in the parents' waiting room. Vending machines are also in this area.
  • Smoking
    Cook Children's Northeast Hospital is a non-smoking facility.
  • Parking
    Free parking is available

After surgery

You will see the doctor after surgery. During this time your child will be sleeping in the Post Anesthesia Care Unit (PACU) or recovery room. Children wake up after surgery at various times, so the receptionist will keep you posted on your child's status. Your child will be transferred to the stepdown recovery room, as soon as he/she is awake. You will be allowed to join your child in stepdown.

If your child is spending the night, he/she will remain in PACU until stable. Then, you will rejoin your child and be taken to your hospital room.

After surgery, your child may seem sleepy, confused, restless or irritable. Your child will be medicated, as ordered by your anesthesiologist, and he/she may be offered something to drink. Please remember that, in most cases, your child will have an IV, which must remain in place until discharge.

Your child's skin may appear puffy and flushed and could be warm to the touch. This normal reaction may continue for several hours and may not disappear until after discharge.

It is important to be calm and to soothe your child as much as possible during his/her stay in stepdown. Encourage your child to take fluids and spend time rocking, singing and reading or talking to him/her.

Going home

Arrangements for transportation home should be made before discharge. Your child will be released only to the person specified on the consent forms. For your child's comfort on the ride home, please have a blanket, a towel and a car seat/booster seat, if needed, in the car before dismissal.

When you get home

Not all children respond to surgery and medication in the same way. However, you may expect:

  • Vomiting
  • Discomfort
  • Sleepiness / limited activity
  • Warm skin
  • Dizziness

To help your child feel more comfortable, we suggest you have at home:

  • Tylenol®
  • Popsicles®
  • Apple juice, Sprite® or 7UP™
  • Soups
  • Jell-O™, pudding or ice cream

If you have questions about what your child can eat after surgery, please ask. We understand that guidelines such as "clear liquids" and "soft, bland food" may not be helpful. There are many foods, even on a restricted diet, that will probably taste good to your child.

About two to three days after your child's surgery, a surgery representative will contact you. Feel free to ask any questions about your child's recovery process. If you have questions at other times, consult your doctor or you may call us at 817-605-2823.