Before Surgery

---

How Do I Prepare My Child For Surgery? 

Sometimes surgery is the only treatment for a heart defect. There are many ways to prepare your child for surgery. The first step is to be honest and use simple language to explain things to your child. Talk about what your child will see, hear, taste, feel, and smell. Don't dwell on things that your child will not directly experience. For example, it is not necessary to tell your child what happens while he or she is asleep during surgery. You can explain that the care team will do their best to fix your child's heart. If you have any questions about how to communicate with your child, you may call the Child Life Department at (801) 662-3701 or the Social Work Department at (801) 662-3700. You can also ask your care team for the handout Let's Talk About ... preparing for surgery.

Children and teens may act differently before, during, and after a hospital stay. Many children act younger than their age by sucking their thumb, wetting the bed, wanting to be with you constantly, or doing other things they have previously "outgrown." These are common reactions and usually go away with time. Let your child or teen know that you understand. Playing doctor, reading books about hospitals, and talking about the experiences can help children. Letting teens feel like they have some control over their experience by making some decisions about their care can help.

The hospital has a pre-surgery preparation class designed for children and teenagers. The class introduces patients to the hospital in a reassuring way. It is held Monday through Thursday, and lasts about 1 hour and 15 minutes. If you and your child or teenager would like to attend, please make reservations by calling Pediatric Education Services at (801) 662-3500.

Your child will need to come to the hospital the day before surgery for a medical history report, a physical, lab work, and a chest x-ray. Please check in at Outpatient Registration no later than 1:00 p.m. They will direct you to the Same Day Surgery Department. If your child is scheduled for surgery on a Monday, you can come on either Saturday or Sunday. Outpatient/Same Day Surgery registration is closed on the weekend. Please go to Emergency Room Registration no later than 9:00 a.m. Saturday or Sunday morning.

 What Happens During Surgery?

You may wait in the inpatient surgery waiting room while your child is in surgery. Your surgeon will give you an approximate time for how long the operation will take. A member of the surgical team will update you periodically during the procedure either in person or on the phone. Don't be alarmed if the surgery takes longer than expected. Normal delays are common, and they usually don't have anything to do with your child's condition.

If you think you have been waiting too long, a number is provided in the waiting room for you to call and check on your child. The surgeon will talk to you in the same waiting room when the surgery is completed.

A note about your surgery time:
The surgery time given to you is an estimate only. It may be affected by many factors such as late arrivals for other surgeries, unexpected trauma cases, and other surgeries taking longer than expected. You child may go to surgery sooner or later that is estimated. In case you have to wait, bring things for you and your child to do.

What Tests Might My Child Have?

Blood and Urine Tests
Blood and urine tests are usually done before surgery. The urine test makes sure there is no infection. Blood tests are done to check for a variety of things in addition to testing for infection, minerals, blood sugar levels, and blood type. If these tests indicate a problem, your child's mineral or sugar levels can be corrected with medicine. Your child's blood type is determined in preparation for any blood that may be needed for surgery.

Cardiac Catheterization (Heart Cath)
A cardiac catheterization, sometimes called a "heart cath" for short, is a way for your doctor to learn more about your child's heart defect. The catheter is inserted through a vein or artery and is then passed into the vessels and chambers of the heart. The cardiologist is able to measure pressures and the amount of oxygen in the blood. The cardiologist injects a dye that can be seen with x-rays and recorded to take pictures of your child's heart. These pictures, along with other information, tell the cardiologist more about your child's heart defect and how it is affecting him. Your child is given medicine before the procedure to help him relax and possibly sleep throughout the procedure. Your doctor tells you how long it will take for the cath to be done. You are asked to wait in the medical imaging waiting area where the cardiologist will talk to you after the cath.

Chest X-rays
X-rays are used to take pictures of the chest and lungs. They can give the doctor information on the size of the heart and the status of your child's lungs. An x-ray machine delivers these invisible rays through the body and onto film. When x rays pass through the body, different tissues absorb them differently. Bone absorbs the most and the air in the lungs and the intestines absorbs the least. The procedure is painless.

Regular x-rays produce good pictures of bones and the lungs (chest x-ray), but in order to see body parts such as the kidneys and blood vessels, contrast media or x-ray dye are used. This contrast media is given through your child's IV (tiny tube inserted into a vein) or by mouth. If your child is allergic to the x-ray dye or contrast media, let the radiology technician know. Some children need to receive sedation medicine so they can relax and keep still for the scan. For more information ask your nurse for the handouts Let's Talk About ... Sedation.

Echocardiogram (echo)
An echocardiogram (echo-CARD-ee-oh-g ra)), sometimes called an "echo" for short, is a painless way of taking a picture of the heart. The echo uses high pitched sound waves (higher than we can hear). This is the same technology used in ultrasounds. Sound waves are sent out through a hand-held probe. The waves reflect off of solid structures, such as the heart, and a very sensitive machine reads them. An echocardiogram uses no radioactivity, and you can stay with your child for the entire procedure. Because children need to stay still for 20 minutes to 1 hour, sometimes a sedation medicine is given.

Electrocardiogram (ECG, EKG) An electrocardiogram (ee-leck-trow-CARD-ee-oh-gram) is a test that measures how the heart works. It is also known as an ECG or an EKG. It helps your health care provider find out if your child has an irregular heartbeat, if your child's heart is bigger than normal, or if the electrical system of the heart is working correctly. An electrocardiogram simply prints on paper the electricity that moves through the heart. Small sticky pads are placed on your child's chest and wires connect these pads to a machine. The entire procedure takes less than 10 minutes. During the exam, your child can sit on your lap to be more comfortable or to help hold still. The test is not painful and there are no side effects.

What Do I Bring to the Hospital?

The hospital provides pajamas and slippers for all patients. You may wish to bring a favorite toy or blanket, labeled with your child's name. We suggest you bring loose-fitting clothing for your child to wear home.

Your child cannot have anything by mouth the morning of surgery (no solids after midnight and no liquids 3 hours before the surgery). This can be difficult for your child to understand, especially if he or she is young. Once again, it is very important that your child follows the diet instructions given by the Same Day Surgery nurse.

Arrival time and surgery time:
Same Day Surgery nurses will call the afternoon or evening before the surgery to let you know what time to be at the hospital. If surgery is scheduled for Monday, they will call Friday.

You will meet the cardiac surgeon and anesthesiologist the morning of surgery. They will go over the operation with you and answer any questions you may have.

Maintain your normal routine before surgery: