Frequently Asked Questions About Having Surgery

Before Surgery

• Why do I have to wait until the night before surgery to find out the exact time of my child's surgery?

  You may be given a tentative time for your child's surgery, but the time often changes because of emergency surgeries or unexpected traumas. While we know it is frustrating, the exact time for surgery cannot be given until the evening before. A nurse will call you the evening before and answer any questions you may have. Generally, infants and toddlers receive priority and are scheduled in the morning.

• When should I be there?

  You will receive a call two business days prior to surgery before telling you when you should be there. In general, please plan to report to the Center for Surgical Care two hours before the scheduled surgery time.

• May I request a private room for my child?

  You may ask for a private room, but it cannot be guaranteed. Private rooms are assigned based on medical necessity.

Day of Surgery

• When I arrive at Children’s, where do I go?

  When you arrive at Children’s, you can park in the visitor parking garage, and go up to the first floor. Personalized directions from your home are also available. All visitors are required to sign in at the Welcome Desk. From there, take the elevators to the second floor, and follow the signs to Surgery. Please bring a photo I.D. to receive a visitor’s badge. Patients age 18 or older must have a photo I.D.

• What do I do when I get to the Center for Surgical Care?

  When you arrive, the first thing you do is check in. After that, you will be directed to registration. After registration, the nurse, anesthesiologist and surgeon will assess your child and interview you. They will discuss the details of their treatment plan and answer any questions you might have. You will be given a pager, similar to the kind that restaurants use, which will buzz when your child’s doctor has an update for you or when it is time for you to be reunited with your child. The pager will work in the cafeteria, and the Costco Wholesale Atrium. The pager will not work outside of the hospital. In keeping with the policy at Children’s National, all female patients who are of menstruating age will have a urine pregnancy test prior to receiving anesthesia. You might be brought to the playroom where your child will be able to play with toys, puzzles and games while waiting for the surgery to start. To help reduce the risk of infection after surgery, please wash or sanitize your hands before and after visiting a patient, using the bathroom and after you sneeze or cough. You are welcome to use any sink or waterless hand gel dispenser to clean hands at any time.

• What happens when it is time for surgery?

  Once care has been assumed by the anesthesiologist, you will go back to the waiting room while your child is transported on a stretcher to the operating room (OR). In the OR, the anesthesiologist will provide anesthesia and continuously monitor your child. Medications will be given during surgery to help your child wake up with minimal discomfort. Once your child’s surgery is complete, the surgeon will discuss the operation with you.

• Where can I get food and refreshments while my child is in surgery?

  The cafeteria is located on the second floor of the hospital. Additionally, Dr. Bear’s Cafe is located on the 7th floor of the East Inpatient Tower. Signs are posted in the building to help find your way. Please remember that no food is allowed in the surgical preparation area out of respect for children who are having surgery, and are not allowed to eat or drink. Many of these children are fasting for surgery and the smell and sight of food can make it more difficult for them.

• Where do I wait while my child is in surgery?

  While your child is in surgery, you will be directed to the family waiting room. You can periodically check in with staff at the information desk to receive an update on your child’s status. You may also want to go to the cafeteria on the second floor of the hospital.

  Once your child’s surgery is complete, you will be paged and the surgeon will discuss the operation with you in a private consultation room.

• Why does my child have an intravenous catheter (IV)?

  In most operative cases, your child will receive an intravenous catheter (IV). The IV is very important. The anesthesiologist will use it throughout the surgery and the recovery nurse will use it while your child is waking up. The IV allows your child to receive hydration and various medications, including pain medication and possible rescue medication. Your recovery nurse will remove it when your child is safe and ready to be discharged.

• Why is my surgery delayed?

  We strive to be on schedule, but occasionally delays do occur. Surgery times are approximated start times. We apologize if there is any delay with your procedure time. Please contact a staff member if you have questions while you are waiting.

• How long will my child’s surgery take?

  Each surgery is different and varies in length. Parents are given a pager (similar to those in a restaurant) that will alert you when the surgeon has an update or when your child is finished.

• What type of anesthesia will my child receive?

  There are many types of anesthesia. Children’s pediatric anesthesiologists will examine your child and talk with you to determine the best option for your child. If you want more information about anesthesia or if your surgeon tells you to contact them, call the Division of Anesthesiology and Pain Medicine at 202-476-2025.

• When will I get to see my child?

  In most cases, parents are reunited with their children in the recovery area soon after surgery. Children’s encourages families to be with their children while they wake up from anesthesia.

After Surgery

• How will I know when my child’s surgery is complete?

  When your child’s surgery is complete, your pager will alert you and you should report to the reception area. The surgeon will update you on the surgery and answer any questions you may have.

• What can I expect after surgery?

  Children respond differently to anesthesia. Some children wake up quickly and may be awake before their families arrive at the bedside. Other children may still be sleeping from the effects of anesthesia. Please do not wake your child; children often have a gentler and more comfortable wake up when they awaken on their own.

  Your child's surgical team will assess your child's recovery and discuss the best option with you. Some children may have an upset stomach; often children are given medications to help decrease the possibility of nausea and vomiting. Some children may have dizziness, or a sore throat due to the use of a breathing tube during surgery. Some children wake up shivering though they are not cold. Encouraging your child to take deep breaths will help.

  Those who have had intravenous (IV) pain medication may have an extremely itchy nose. This itch will go away. All of these reactions are normal. Some children wake up restless or irritable, in a condition known as “emergence delirium.” Some appear awake but are not aware of what is going on around them. Some cry, thrash, arch their back, reach out and seem inconsolable, even when they are in their parent’s arms. This behavior is not usually related to pain, and children do not usually remember it. Emergence delirium may be upsetting for you to see, but be assured that it will go away. By staying calm, speaking softly, and remaining at the bedside, you can be a comfort to your child.

  Your nurse will be at the bedside to reassure and support you in consoling and comforting your child. As a result of the surgery and the anesthetic, you may see changes in your child’s sleep and behavioral patterns. If changes occur, it may take several days for your child to return to normal. If concerns persist, please contact your surgeon or anesthesiologist.

• When will I be reunited with my child?

  Your child will be observed for a period of time in the Recovery Center. The surgical staff will reunite you with your child as soon as possible. While in the Recovery Center, the nursing staff will monitor your child’s vital signs, pain control and responsiveness (waking-up). The length of stay in the Recovery Center varies; however, you should expect your child to stay at least one hour. You can remain with your child through the recovery process and until it is time to go home or be transferred to the inpatient unit.

• Will my child be in pain?

  Children’s National is dedicated to keeping your child comfortable after surgery with the least number of side effects possible. Your child may experience some discomfort or even pain following surgery. Managing your child’s pain is very important to us and we try to control pain before your child comes out of the operating room. Sometimes it is necessary to give additional pain medicine.

  Depending on the severity of your child’s surgical procedure, a special Pain Medicine consultant may be involved in your child’s post-operative care. Parents and caregivers can help by telling your child’s care team what has worked to help soothe your child’s pain in the past, and by supporting their child by holding their hand, rocking, cradling or cuddling. Comfort your child by bringing a favorite security object, such as a blanket, stuffed animal or pacifier. Please address any other questions or concerns you have with your child’s nurse, anesthesiologist or surgeon.

• Will my child have to stay in the hospital after surgery?

  The majority of surgeries at Children’s National are performed on an outpatient basis, meaning children will not need to be admitted for overnight stay at the hospital. Parents are reunited with their children soon after surgery so they can be with them while they wake up and recover. Your child’s surgical team will assess your child’s recovery and discuss the best option with you. If your child is admitted to the hospital to stay overnight in the Recovery Center for extended observation, one parent or caregiver is required to stay overnight with their child. While in the Recovery Center, the staff will make your stay as comfortable as possible.

• If I have more questions, who should I call?

  For questions about your child’s surgery, call 202-476-3370 to speak with the Surgical Prep nurse.

• When should my child return for follow-up care?

  In most cases your child will need to see the surgeon four to six weeks after surgery. At the time your child's surgery is scheduled, a post-operative visit will also be scheduled at one of Children’s specialty care locations or at the main hospital.

Leaving the hospital and follow up

• What are the criteria for going home?

  Your child should be awake and alert, tolerating clear liquids and his or her pain should be under control prior to going home.

  We recommend that you or another responsible adult supervise your child closely on the day of surgery.

• What can I expect when we get home?

  We recommend that you or another responsible adult supervise your child closely on the day of surgery. Your child may be drowsy and may nap or sleep on and off the rest of the day. Your surgeon may limit your child’s activity after surgery and provide further instruction.

  A nurse will call you a day or two after your child’s surgery to follow your child’s progress and to assist you with questions you may have.

• What if I have questions?

  If you have questions or concerns, you may call the Recovery Center Monday through Friday, at any time, and Saturday and Sunday, 7 am - 7:30 pm, at 202-476-5122. An anesthesiologist can be reached 24 hours a day, 7 days a week, by calling 202-476-5000.

• What is the going home process?

  The nurse will review all the discharge instructions for your child’s care at home, which will include: diet, activity, pain medications, follow-up appointments, call center appointment line number, possible post-operative complications and phone numbers to call if you have a problem or question. Please feel free to ask questions about discharge instructions or request more instruction if you have concerns about taking care of your child at home. When it is time to go home, you may assist your child in changing into their clothes while in the Recovery Center. You may carry or use a stroller to the exit. If your child needs a wheel chair you will be escorted to the exit. Please make arrangements in advance for transportation home. Follow-up appointments may be made at locations nearest you where many of our specialty care locations in Maryland and Virginia are located.

• When will my child be able to go home?

  Your child’s surgical team will continually monitor your child’s recovery and communicate with you throughout the process. Your child’s care team will determine the best and safest time for your child to go home.