Countdown to Surgery: Are You Prepared?

Taking these necessary steps before your child’s surgical procedure helps ensure a successful outcome.

girl in hospital bed with father and doctor

Once your child is scheduled for surgery, there are several important steps you need to take to help ensure a safe and successful procedure. Easing any pre-surgery jitters is a large part of the process but making sure your child is physically prepared is just as important. Knowing what to do in the weeks, days, and hours before the operation can help ensure the best possible outcome.

Pre-operative instructions vary among patients, depending on factors including their age, specific operation, and medical history. It’s important to closely follow these individualized directions to avoid complications or surgical delays, says Mark McCollum, MD, a pediatric surgeon at Orange Park Medical Center in Orange Park, Florida.

Still, there are general guidelines most anyone needs to follow to be physically ready for surgery.

Weeks or days before surgery

Be medication savvy. Make a list of all the prescription and over-the-counter medications or supplements your child takes. Note dosages and how often your child takes these drugs or products. Your healthcare provider will tell you what your child should continue taking as well as what medicines and supplements should not be taken before surgery and when to stop taking them.

Anything that could interfere with blood clotting—including many over-the-counter medications, such as ibuprofen and herbal supplements—should be avoided before the operation. Exactly when your child should stop taking them will depend on the specific medication or supplement involved. It’s also important to let the medical team know if your child has an allergy to any medications or food as well as anything that could cause skin irritation, such as latex.

Monitor your child’s health. Call your doctor if your child develops any signs of illness, such as a rash, runny nose, a sore throat, fever, or irritability within a week of the scheduled surgery, Dr. McCollum advises. Your child may need treatment before the procedure, or it may be delayed until your child has recovered.

Boost nutrition. Surgery stresses the body, so going into it as strong as possible can help achieve a good outcome. Optimizing your child’s nutrition with a well-balanced diet—rich in fruits, vegetables, whole grains and protein—can help support a healthy immune system and promote wound healing, which may shorten post-op recovery time.

Meet the anesthesia team. This is often done on surgery day. But, if your child is undergoing a complex procedure or has other health issues, you may meet ahead of time with the doctors who will keep your child sedated during the surgery. Your child may also need additional tests or exams so doctors can provide anesthesia safely, McCollum says.

Take a pre-surgery tour. Some hospitals offer tours, which allow children who are scheduled to have surgery to see the facility where they will be treated and to meet the staff. This also provides them with an opportunity to ask any questions they may have before the day of their procedure. This is especially useful if your child is having a complicated operation and may have a lengthy hospital stay. Knowing what to expect may help ease anxiety and help your child feel more in control.

If the hospital doesn’t offer a tour, your child’s doctor can explain in an age-appropriate way what to expect and address any questions.

Prep your home. For anyone who has undergone surgery, getting around the house and performing normal daily tasks may be difficult. Your child is no different.

It’s important to make accommodations to your home environment to make recovery from surgery as stress-free as possible. Your child’s surgeon or another healthcare provider, such as an occupational or physical therapist, can help you determine what adjustments to make. For instance, you may need to move your child to a bedroom on a lower floor or move them closer to a bathroom. Make any necessary changes a few days before the procedure. 

As the surgery date approaches

In the days leading up to your child’s procedure, your healthcare team will give you personalized instructions that are specific to your child. They will tell you the time of your child’s procedure and when you should arrive at the hospital. You’ll also review which medications your child may take and what is off limits and when to stop food and liquids. If you don’t receive this advice, follow up with your child’s surgeon or hospital. 

Follow fasting rules: Your child’s stomach needs to be empty before anesthesia to keep food and liquids out of his or her lungs. Each hospital has slightly different rules and your medical team will tell you what is recommended for your child, McCollum says.

But general guidelines are: Older children and teens shouldn’t eat or drink anything other than clear liquids after midnight, or eight hours before anesthesia. Younger kids should avoid solid food six to eight hours before surgery. These include some items you might not think of:

  • Candy and chewing gum
  • Milk  
  • Orange juice

Kids—even older children and teens—can have clear liquids up to two hours before surgery. These include any drinks that you can see through and don’t have pulp:

  • Gelatin (Jell-O) or one popsicle with no fruit
  • Apple or white grape juice
  • Sports drinks, such as Gatorade, or Pedialyte
  • Clear broth
  • Water

Infants younger than 1 year old may have:

  • Solid food, which includes baby food and baby cereals, up to eight hours before surgery
  • Infant formula may be given up to six hours before surgery and breast milk can be given up to four hours before the procedure, according to the American Academy of Pediatrics.

The day of surgery

Bathe your child: Make sure your child has a bath or shower in the morning or before bedtime the night before surgery. If your doctor gave your special wipes to cleanse the surgical area, don’t forget to use them. Don’t shave any area before surgery. If this is necessary, it will be done in the operating room, McCollum says. If you child is wearing nail polish or artificial nails, these should be removed.

Dress comfortably: On the morning of surgery, dress your child in loose-fitting clothes and be sure to leave jewelry and other personal accessories at home.

Bring a comfort item: Pack a stuffed animal, book, favorite toy, or blanket. This soothing item will help ease the transition from the familiar environment of home to the unfamiliar hospital, McCollum says.

Leave for the hospital on time: If you’re late, the procedure could be delayed or postponed. The surgery center follows specific protocols to keep your child safe and these steps take time:

  • Hospital staff will go over your child’s health history, make sure all pre-op instructions were followed and take vital signs, which includes listening to your child’s heart and checking his or her blood pressure and temperature.
  • After your child puts on a hospital gown, you should have an opportunity to ask any last-minute questions you have about the surgery. The surgical team may “mark” the spot of surgery on your child’s body with a marker.
  • You’ll talk to the anesthesia team and review how your child will be sedated. General anesthesia is either inhaled through a mask or given intravenously. The doctor may give your child medicine to calm nerves prior to starting anesthesia. Anesthesia is safer today than ever before. But, discuss any last-minute concerns that you or your child have, including how pain will be managed after surgery.  

When it’s time for the procedure to begin, your child will be transported to the operating room. Keep in mind that surgical teams are specially trained to make this transition as smooth as possible for parents and kids, McCollum stresses. Be calm and reassure your child that you will be in the recovery room when surgery is complete.



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