Outpatient Surgery
Welcome to East Tennessee Children's Hospital Surgical Services. You may have many questions about your child's surgery. We hope this will answer some frequently asked questions. We want your stay to be as comfortable as possible. You will have all of the specialized services of Children's Hospital immediately available if needed by your child during his/her surgery experience.
What is the Difference between Outpatient Surgery and Inpatient Surgery?
Outpatient surgery is when your child comes to the hospital for a minor surgical procedure and leaves the same day. Inpatient surgery is when your child stays in the hospital overnight after his or her surgery. Most of the time, your child will come to the hospital the day of surgery if he or she is to spend the night. Some children are admitted in an observation status and leave the hospital within 24 hours.
Scheduling and Arrival Time:
Many doctors or offices tell you a time for your child's surgery when you are in the office. Sometimes we have emergencies or changes in doctor schedules. This may change the time of your child's surgery from the time your doctor told you. Children's Hospital Outpatient Surgery will call one to two days before your child's surgery to give you the most up-to-date arrival time.
Call (865) 541-8402 if Children's Hospital does not call you by 5:30 p.m. the day before surgery. Outpatient Surgery is open Monday-Friday until 7 p.m. The Inpatient Surgery Unit can answer your questions after 7 p.m. or on weekends or holidays. The Inpatient surgery number is (865) 541-8580.
Ronald McDonald House
Ronald McDonald House is available for those who live a distance away from Children's Hospital; the house is three blocks away from the hospital. The usual charge is $5 each night. The charge can be waived if a family cannot afford to pay. Reservations are required and must be made by your surgeon's office; notify your surgeon's office if you are interested in staying at the Ronald McDonald House.
Parking Instructions:
Parking is provided in the East Tennessee Children's Hospital parking garage located on Clinch Avenue between 21st and 22nd streets. A parking pass will be given to one family member at the time of admission. Please do not park in the Emergency Department Parking lot. You may enter the hospital:
- Main entrance at the corner of Clinch Avenue & 21st Street between 5:30 a.m. and 9:30 p.m.
- Medical Office Building between 6 a.m. and 6 p.m. Then use the crosswalk to get to the Main Lobby.
- Emergency Department entrance is open 24 hours a day every day of the week.
Parking Garage map
Before Surgery
Food and Drink:
Directions for all children:
- Regular diet until 11 p.m. the night before surgery.
- We will not be able to do your child's surgery if your child has had
- Gum
- Candy or breath mints
- Even one bite of solid food
- Milk
- Jello
None of this can be given after 11 p.m. the night before surgery. Chewing gum or sucking on hard candy or breath mints makes the stomach produce juices. This can increase the risk of stomach juices getting into the airway. This could be very dangerous for your child. We want your child to be as safe as possible during surgery.
If your child's surgery is later in the morning, or in the afternoon, your child may be able to have clear liquids for a time before surgery. Your child's nurse will give you exact directions when to stop fluids. Again, no child can have solid food or milk after 11p.m. the night before surgery.
- Clear liquids include water, Powerade or Gatorade, apple juice or Sprite.
- Jell-O is NOT a clear liquid.
We have special guidelines for feeding infants formula and breast milk and will give them to you when we call. We will call and give exact instructions for your child one to two days prior to surgery.
Medications:
We need to know what medicine your child takes. We ask that you bring a list of ALL current medicines your child is taking along with the dosage and how often it is taken. Make sure you include:
- Over-the-counter medications and vitamins
- Herbal supplements
If you prefer, just put all of your child's medication bottles in a bag and bring them with you when you bring your child to Children's Hospital.
We will tell you to give medicines for these conditions the morning of surgery:
- Heart disease
- Blood pressure
- Seizures
- Breathing treatments or inhalers to help with breathing
If your child cannot swallow a pill, please give the medicine in a teaspoon of apple juice or water. Do NOT put your child's medicine in pudding or applesauce. If your child takes breathing treatments or uses an inhaler on a regular basis, please give him or her regular breathing medications the day of surgery.
Things to Think About:
We would like your child to be as comfortable as possible so:
- Please bring a favorite toy or blanket from home.
- Wear comfortable clothing.
- Make sure that ponytail holders do not contain metal.
- Bring extra diapers and a change of clothing for your child.
If you are the legal guardian of a patient, please come prepared with a copy of custody papers.
These papers must be signed by a judge and notarized.
Call your doctor if your child has a fever above 100 degrees Fahrenheit and cold or flu-like symptoms within two weeks of surgery. It is especially important to call your child's doctor if your child gets ill within two days of surgery.
Please keep in mind that some surgeries may take longer than anticipated, as emergencies can occur. This may cause your child's surgery to be delayed. We will do our best to ensure your child gets to surgery in a timely manner. We ask that you allow extra time when planning for appointments or making arrangements for other children.
For your child's safety:
- All jewelry, contacts and nail polish need to be removed before surgery.
- If your child has body piercings, please make sure that they are removed before surgery.
Talking to your child about surgery:
- Be honest. Answer any questions your child has about the surgery
- Tell him/her about blood tests or any other procedures that you know may happen. Our nurses will tell you one to two days before surgery if your child will need lab work.
- Tell your child that doctors and nurses are there to help them stay well and get better when they are sick.
- Preadmission Tours are done each Monday and Thursday at 7:00 p.m. You can schedule a tour with the Child Life Department by calling (865) 541-8904.
Day of Surgery
Admission to Children's Hospital
We are happy to serve ALL the children of East Tennessee and surrounding areas. For this reason, it may be necessary for you to share a room. We will do our best to ensure the comfort and privacy of all patients and families.
If you have a roommate:
- Parents are encouraged to stay with their child at all times. Additional visitors may wait in the lobby on the first floor and take turns visiting so that there is room for everyone.
- Your child's roommate may not be allowed to eat or drink. Please be considerate.
- Consider noise levels if the other child is sleeping.
- Pull curtains around the beds to help with privacy.
Your child will be admitted to a room until time for the surgery or special procedure. Your child will then be returned to the room following surgery. Please do not leave the floor without telling your child's nurse.
Anesthesia
The Anesthesia group at Children's Hospital takes care of children during surgery. The group is made up of specially trained doctors (Anesthesiologists) and nurses (Certified Registered Nurse Anesthetists, also called CRNAs). They will monitor your child's breathing, heart rate, oxygen level and blood pressure during surgery and keep your child asleep during surgery. After surgery, the anesthesiologist may be asked by your child's surgeon to help with treating your child's pain.
Preparing for Anesthesia
A nurse or doctor from the Anesthesia group will meet with you the morning of surgery. They will ask questions to be sure your child is well enough to have surgery. The doctor or CRNA will explain the plan for anesthesia. You may ask questions or express your feelings or concerns at this time.
Please make sure you tell the Anesthesia group about your child's:
- Allergies, asthma, past surgeries and hospital stays.
- Any recent illness. If your child is ill, he/she may need to wait until feeling better to have surgery.
- All medicines, vitamins and herbal supplements that your child is taking.
- Problems that your child or anyone else in your family had with anesthesia.
Anesthesia Plan
The anesthesiologist (doctor who puts your child to sleep)
may order a medication to be given before surgery. This medication (“happy juice”) may make your child sleepy, but not always. Some children act silly and see double—this is normal. Please do not allow your child to get out of bed after getting the “happy juice,” as he/she could fall and be injured.
There are a few ways to start anesthesia (medicine that makes your child go to sleep) after your child is in surgery. If your child has an IV (a tiny straw in the vein), medicine can be put in the IV. Your child will go under anesthesia quickly.
Most children do not have an IV before surgery. These children go to sleep by breathing anesthesia gases through a mask, and the IV is started after the child goes to sleep.
The doctor or CRNA will decide which way is best for your child. They will stay beside your child all the time during surgery. Their only job during surgery is to watch your child and treat any problems.
Pain Control
Your doctor may ask the Anesthesia Group to help with pain control for your child if he or she is spending the night after surgery. One common way is with a patient-controlled analgesia (PCA) pump. This small pump has a button that your child can push to give small amounts of pain medicine as needed. You can ask for the Anesthesia Group to help if your child's pain is not well controlled.
Phone Consults
You or your doctor can call us if your child has a special medical problem before the day of surgery. You or your doctor can also call us if you have a concern about the planned anesthesia care. You can talk to an Anesthesiologist at (865) 541-8485.
Holding Room
You will go with your child to the Holding Room and meet the Anesthesiologist. You may also meet your child's surgeon or dentist.
While your child is in surgery, you will wait in the Surgery Waiting Room. Please do not leave the Waiting Room before you have talked with your surgeon or dentist after the surgery. They will come talk to you as soon as the surgery is finished.
PACU (Post Anesthesia Care Unit)
PACU (Post Anesthesia Care Unit) staff will bring your child back to the room as soon as your child is awake enough to realize that he/she is away from you. PACU staff will call you in your room as soon as your child is comfortable. Children usually stay in the PACU 30 minutes to 1 hour, but sometimes may stay longer if they are unusually sleepy. If your child's stay is prolonged, the PACU nurse will call you in your room to update you on how your child is doing.
Many children get pain medicine in the PACU. After surgery, your child may be sleepy for several hours. Some may have nausea and vomiting. Some children may be confused or agitated. These are common after surgery and will soon go away.
After Surgery
Outpatient Surgery:
The nursing staff will observe your child until he/she is ready to go home.
- How long you stay will depend on the type of surgery your child had, and how sleepy your child is after surgery.
- Most children are ready to go home in one to four hours.
- Please do not let your child get up without help until your nurse tells you it is safe.
- Your nurse will tell you when you may give your child solid foods after surgery. Feeding your child solid foods too soon may upset your child's stomach.
- Most children have IVs (a straw in the vein to give fluids or medicine) when they return from surgery. It does not hurt but does bother children. We will take it out as soon as your child can keep fluids down without vomiting, unless your doctor tells us that it must stay in.
Inpatient Surgery/23 Hour Admissions:
If your child must spend the night after surgery, you will be moved to another unit. We will transfer you to the other unit as soon as the room is available.
After Discharge
Call your doctor immediately if:
- Your child has a fever above 101.5.
- Pain medication is not working.
- Your child is not keeping down liquids.
- Bleeding is more than what your nurse told you to expect.
We will call you in a few days after you go home to see how your child is feeling. We may be able to help you with questions at that time.
Preventing Surgical Site Infections
We do everything within our means to prevent infections due to surgery. There are several things that you can do to help us:
Before Surgery:
- Patients should take a bath or shower and wash hair the night before surgery.
- Do not shave around the site of surgery the night before surgery.
- Ask EVERYONE who comes in your room if they have washed their hands or used hand sanitizer.
- If you smoke, try to stop before surgery.
- Tell the surgeon if the patient has a fever.
- Tell your caregivers if the patient has piercings, antibiotic resistance or a tampon in place.
After Surgery:
- Wash your hands carefully anytime you get them dirty, especially after you go to the bathroom.
- Let your nurse know if the sheets or gown are dirty.
- Report loose or wet dressings over IVs or incisions.
- Let the nurse know if a tube comes loose.
- Make sure the patient moves around or walks a lot after surgery. This will help prevent pneumonia.
- Make sure the patient takes deep breaths to clear the lungs. Blowing bubbles is a good way to do this!
- Make sure to follow feeding instructions.
- Make sure the patient takes all antibiotics that are prescribed.
- Tell the surgeon if the patient has a fever.
- Make sure visitors do not have a fever or infection.
We thank you very much for choosing East Tennessee Children's Hospital for your child's surgery. We hope you and your family have an excellent experience. If you have any questions or concerns, please feel free to contact us at (865) 541-8402.
Map to Children's Hospital