When Your Child Needs Surgery: The Day of Surgery

Your child is having surgery. This can feel scary for you and your child. But knowing what to expect can help both of you feel better. This sheet tells you what happens when it's time for surgery. And it tells you how to help your child after surgery.

At home before surgery

If your child gets a fever or a cold in the days before surgery, call the hospital or surgeon’s office and let them know. The surgery may need to be rescheduled. This is for your child’s safety.

Follow all food, drink, and medicine directions from your child’s healthcare provider. This may mean that your child can have nothing to eat or drink for a set amount of time before surgery.

What to bring to the hospital

Following are items that you may need to bring with you to the hospital:

• Identification for you and your child (such as a driver’s license or Social Security card)

• Health insurance cards

• Proof of guardianship (if you are not the child’s natural parent)

• Medical records for your child

• List of medicines your child takes

• Comfort item for your child, such as a toy or blanket

• Extra underwear or diapers for your child

• Extra clothing for you and your child if an overnight stay or longer is expected

• Books, toys, or games for your child

In the hospital before surgery

• You need to check in at the hospital at the time you were told. Make sure to arrive on time.

• You may be asked to register your child for surgery. This can sometimes be done in advance during an earlier hospital visit, on the phone, or online.

• There may be a waiting period before your child is prepared for surgery. Have toys and games ready to help them relax during this time.

• A nurse will meet with you and your child.

• Your child will change out of their clothes and into a hospital gown. A hospital ID bracelet will be put on their wrist.

• Your child may keep a comfort item, such as a favorite toy or blanket with them.

• The nurse will check your child’s vital signs. These include temperature, blood pressure, heart rate, and breathing. You’ll be asked about your child’s health history. And you will be asked when your child last had anything to eat or drink. Other staff members will also likely ask you these same questions when you meet them later.

• Your child’s surgeon may come meet with you and your child shortly before surgery. Ask any questions you have.

• The anesthesiologist will also meet with you. This is a doctor who has been trained to give anesthesia. The anesthesiologist will explain the type of anesthesia your child will have. One type is general anesthesia. This medicine causes your child to fall asleep and not feel pain during surgery. 

• Your child may first be given a sedative before receiving anesthesia. A sedative is medicine that helps your child relax. It may be given by mouth with a sip of water.

• Anesthesia may be started in a room called an induction room. Or it may be started in the operating room. It can be given in gas form and breathed in through a mask. It may be given in liquid form through an IV (intravenous) line. Or both may be used.

• You may be allowed to stay with your child until they are asleep. Check with your child’s anesthesiologist.

• A resident or trainee working under the direction of your child's anesthesiologist or surgeon may help with your child's care.

During surgery

• A pediatric surgeon will do the surgery. The surgeon may be assisted by other surgeons and nurses.

• The anesthesiologist will control the amount of anesthesia your child receives. They may be assisted by a nurse anesthetist. This person also has had special training to give anesthesia. Your child’s vital signs are watched. Anesthesia is stopped when the surgery is done.

After surgery

• Your child will be taken to a postanesthesia care unit (PACU) or a recovery room.

• You may be allowed to stay in the PACU or recovery room with your child. Every child reacts differently to anesthesia. Your child may wake up confused, upset, or crying. These reactions are normal. They often pass quickly.

• Incisions (cuts) may be covered with a bandage or dressing.

• Your child will be given pain medicine to stay comfortable. These may be given through an IV line.

• Your child’s vital signs will be watched.

• When ready, your child will be given clear liquids after surgery. Then slowly, your child will be given solid foods and return to a normal diet.

• The surgeon will tell you if your child can go home or needs to stay longer in the hospital after surgery. 

• You will get discharge and home care directions when your child leaves the hospital. Be sure to follow these directions.

When to call your child's healthcare provider

At home, call the healthcare provider right away if your child has any of these:

• Nausea or vomiting

• A sore throat that doesn’t go away

• Pain gets worse

• Fever (see Fever and children below)

Fever and children

Use a digital thermometer to check your child’s temperature. Don’t use a mercury thermometer. There are different kinds and uses of digital thermometers. They include:

• Rectal. For children younger than 3 years, a rectal temperature is the most accurate.

• Forehead (temporal). This works for children age 3 months and older. If a child under 3 months old has signs of illness, this can be used for a first pass. The provider may want to confirm with a rectal temperature.

• Ear (tympanic). Ear temperatures are accurate after 6 months of age, but not before.

• Armpit (axillary). This is the least reliable but may be used for a first pass to check a child of any age with signs of illness. The provider may want to confirm with a rectal temperature.

• Mouth (oral). Don’t use a thermometer in your child’s mouth until they are at least 4 years old.

Use a rectal thermometer with care. Follow the product maker’s directions for correct use. Insert it gently. Label it and make sure it’s not used in the mouth. It may pass on germs from the stool. If you don’t feel OK using a rectal thermometer, ask the healthcare provider what type to use instead. When you talk with any healthcare provider about your child’s fever, tell them which type you used.

Below is when to call the healthcare provider if your child has a fever. Your child’s healthcare provider may give you different numbers. Follow their instructions.

When to call a healthcare provider about your child’s fever

For a baby under 3 months old:

• First, ask your child’s healthcare provider how you should take the temperature.

• Rectal or forehead: 100.4°F (38°C) or higher

• Armpit: 99°F (37.2°C) or higher

• A fever of ___________as advised by the provider

For a child age 3 months to 36 months (3 years):

• Rectal or forehead: 102°F (38.9°C) or higher

• Ear (only for use over age 6 months): 102°F (38.9°C) or higher

• A fever of ___________ as advised by the provider

In these cases:

• Armpit temperature of 103°F (39.4°C) or higher in a child of any age

• Temperature of 104°F (40°C) or higher in a child of any age

• A fever of ___________ as advised by the provider