Date issued: November 2020
For review: November 2022
Ref: D-71/W&C/Plym/HI/info for parents&children v9
(Based in Freedom, Level 2)
The unit is open 7.45am to 7.30pm Monday to Friday
If for any reason your child cannot attend their
operation on the day planned please contact the unit as soon as possible.
Welcome to Plym Children’s Theatres
Plym Children's Theatres are situated on level 2 of the hospital. * It is situated within Freedom Unit towards the rear of the main hospital. From the multi storey car park: make your way down the hill past maternity and past the Terance Lewis building to the bottom of the hill. (A map is available towards the end of this booklet) There is a drop off zone outside the unit.
We specialise in many different children's surgical specialities.
*Please note, if you have visited us before, our location has now changed and we are no longer based on level 6 by the main entrance.
Preparing your child
For many families, coming in for surgery is an event that can trigger a range of emotions. It is important that children are suitably prepared for this, and so we suggest that you should;
- Explain that they are coming into hospital and explain in a simple and honest way what they are having done.
- Explain that they will be looked after by the doctors and nurses, but you will also be near whilst they have their operation/ procedure.
- Explain that there will also be other children having operations and they will be able to play in the play rooms whilst they are waiting for their operation.
Ways to help
Explain that the operation/procedure will make things better.
Encourage your child to talk about the operation and ask questions. Books and games can help.
Encourage them to pack their own bag for their trip to hospital, ask them what they think they’d like to have, maybe a special or favourite soft toy.
If your child needs to stay in hospital overnight, reassure them that one adult can stay with them all night and others can visit them when they’re feeling better.
Daycase surgery or Inpatient surgery
Certain operations can be done as a daycase procedure. This means that if it is appropriate your child can go home the same day as their surgery/ procedure.
The decision as to whether your child can be a daycase procedure will usually be discussed with you at your pre-operative appointment and will be determined by a number of criteria.
However, it is important to bring an overnight bag for all children in case an overnight stay is needed.
If your child does need to stay overnight they can have one adult to stay with them. The length of stay will depend on your child’s needs. Usually this can be discussed in advance.
Fasting information/ Nil by Mouth
It is essential that all children follow the fasting instructions below. If your child fails to follow these instructions it could result in their operation being cancelled. Children can have a clear fluids up-to one hour before an anaesthetic.
Last meal or snack
3 hours before surgery
Formula fed Milk
4 hours before surgery
No food after midnight.
Clear fluids up until 08:00 am
No food after 07:30am
Clear fluids up until 12:30pm
Please note clear fluids are water or dilute squash. Please do not allow your child to have any fizzy drinks, milk or fresh fruit juice.
Before Your Child’s Anaesthetic
A general anaesthetic ensures that your child is unconscious and free of pain during their operation/ procedure. They will be cared for by an anaesthetist who is a specialist doctor responsible for the care and wellbeing of your child throughout their operation. The anaesthetist will also ensure your child’s pain will be managed following the operation.
Most children will have local anaesthetic cream (magic cream) applied to the back of their hand, foot or inner elbow when they are admitted. This will numb their skin ready for a cannula to be inserted for their operation/ procedure.
The cream takes around 40 minutes to take effect and will keep the area of your child’s cannula comfortable when they wake up.
A cannula is a small medical device that is placed into a vein, usually on the back of your child’s hand or foot. This small plastic tube will be used to give medicines during and after your child’s procedure/ operation.
We like to use the words “medicine straw” to describe the cannula. Please don’t mention needles to your child.
All children having a general anaesthetic will have a cannula during their operation, to allow us to give medicines and fluids. This will be removed as soon as it is safe to do so.
How will my child go to sleep?
There are two methods of going to sleep and these will be discussed with you by the anaesthetist on the day of your child’s operation/ procedure.
The method in which your child will go to sleep will depend on a number of factors such as age and medical history.
The two methods of going under anaesthesia/ going to sleep are;
- Anaesthetic gas induction, the anaesthetist will use a face mask to give anaesthetic gases. It can smell like felt-tip pens. It may take a minute or so for your child to become anesthetised and they may become wriggly/ restless as the gases take effect. Once asleep the anaesthetist will then insert a cannula in order to give your child medicines whilst they are asleep.
Intravenous induction, Intravenous inductions are a quicker method of going to sleep. To do this the anaesthetist will administer anaesthetic medicine into your child via a cannula. Children having an intravenous induction are usually asleep within a few seconds.
A pre-med is the name for medicines which are sometimes given before an anaesthetic. Some pre-meds help your child to relax, some are for pain relief and some are related to the surgery your child is having.
Not all children will require a pre-med
Pain relief medicines are given before, during and after your child’s operation to ensure that your child remains comfortable. There are a wide range of medicines available, and the anaesthetist will be responsible for deciding which medicines are most appropriate.
All children who are having surgery should have paracetamol and ibuprofen available at home for them post operatively.
Please ensure that adequate pain relief is available at home for your child. In some cases it will be appropriate for your child to be sent home with stronger pain relief medicines, or to be managed on a variety of pain relief medicines if they are an inpatient;
- Intravenous (IV), medicines given into a vein via a cannula
- Infusion, when medicines are continually administered via a special pump
- PCA, Patient Controlled Analgesia, an infusion of pain relief medicines that are controlled by a button given to the patient. This will be explained thoroughly if your child requires one.
- Epidural, an injection or infusion of local anaesthetic around the spine (started whilst asleep) and may be in place for a few days.
- Caudal an injection of local anaesthetic around the nerves as they leave the spine, similar to an epidural (whilst asleep).
Day of operation/ procedure
What to bring
- Any regular medicine/inhalers your child is taking
- Loose fitting cotton nightwear (for some procedures a gown will be provided)/ Spare set of clothes and spare nappies
- An overnight bag in case your child stays in
- Favourite cuddly toy/ comforter to take to theatre. Ipad/ tablet or book to keep your child entertained
- Change for parking and refreshments
- Foods/ snacks/ formula for afterwards. Bottle/ beaker to drink from
Before the operation
A nurse will collect your child and prepare them for surgery. They will ask you a range of questions, apply ‘magic cream’, record your child’s heart rate, oxygen levels and temperature and ensure they are ready to go to theatre.
An anaesthetist will then discuss your child’s anaesthetic and pain relief options. They will be able to answer any further questions you may have.
The surgeon will then discuss the procedure with you and your child and ask you to sign a consent form. In some occasions your child may be able to consent for their own surgery, but it is essential that a parent or legal guardian is available to support them during this process.
Once ready for theatre your child may have to wait for a period of time before their surgery/ procedure.
Going into theatre
The anaesthetic room
When it is your child’s turn to go to theatre, a member of the theatre team will take you to the anaesthetic room.
For most cases one adult will be allowed to accompany the child to theatre, if they and the child wish to do so.
However, there may be certain situations when this is not possible. Once your child is asleep you will be taken back to the parents’ waiting room. This is where you will be collected from once your child is awake.
First stage recovery
Once your child’s surgery has finished they will be taken into our first stage recovery area. There will be at least one nurse dedicated to recovering your child. They will stay with your child until they are suitably recovered from the anaesthetic. Children will usually spend a while sleeping after the operation, it is not unusual for there to be a delay in reuniting you with your child. It isn’t unusual for children to wake up disorientated. Please don't be alarmed if this happens to your child.
Second stage recovery
During second stage recovery we will ensure that your child is comfortable and well. They will need to eat and drink before they are safe for discharge home. We can offer a selection of foods and snacks, however if your chid has a specific dietary need/ food allergy it is a good idea to bring in some food from home.
The time you and your child spend in second stage recovery will depend on how quickly your child recovers from anaesthetic and will very between procedures. If your child is staying overnight we will transfer you up to ward as soon as is appropriate.
Third stage recovery
Once your child has met a range of set criteria and they are well enough to go home, your nurse will ensure that you have all the necessary information you need. If your child needs any medicines they will also give these to you and explain how to use them safely. Finally they will remove the cannula and you will be able to take your child home.
Recovering at home
Following a general anaesthetic your child will need to stay off school for at least 24 hours, during which they must have close adult supervision. Some surgeries will require your child to stay off school for longer. If this is the case you will be informed of this at your pre-operative assessment.
How to find us:
Plym Children's Theatres are situated on level 2 of the hospital. * It is situated within Freedom Unit towards the rear of the main hospital.
See some of the Teddies and cuddly friends that have visited Plym!
Watch Toby has an anaesthetic!