Display Patient Information Leaflets

Welcome to Children's Theatres

Posted Wednesday, 25 November 2020

Date issued: May 2024

For review: May 2026

Ref: D-71/MR/Plym/childrens theatre v13

PDF: Welcome to Children's theatres.pdf[pdf] 646KB

How to find us

Children’s Theatres are situated in the South West Peninsula Children’s Surgical Unit, on level 2. Please note that Children’s theatres have a separate entrance at the rear of the hospital. We suggest parking in the multi-storey car park and walk past the Chestnut Unit, head down the hill towards the Peninsula Heart Clinic. There is also a drop off area outside. (We are no longer beside the main entrance, level 6) If you enter via the main hospital building you will need to go to level 3, follow the signs for Children’s theatres, exiting the building via the level 3 coffee shop, the Childrens Surgical Unit entrance is situated to the left of the main building opposite the Peninsula Heart Clinic.

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 and so we suggest that you:

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 with them whilst they are awake, and nearby whilst they have their operation/ procedure. If your child needs to stay overnight, reassure them that 1 adult can stay with them overnight and others can visit.
Explain that there will be other children having operations and they will be in the waiting room and recovery room as well.

Ways to help

Explain that the operation/procedure will make things better. Encourage your child to talk about the operation and ask questions. Encourage them to pack their own bag for their trip to hospital, choosing a favourite toy to bring

Please read the age-appropriate booklet 'Rees Bear and Davy the Detective'

Take a virtual tour of the unit

Facebook Links

For the guided tour and information:

South West Peninsular Children's Surgery Unit

Look at the teddies and soft toys who come to visit:

Plymouth Children's Theatres visiting Toy Gallery

What to bring on the Day

Any regular medicine/inhalers your child is taking.
A dressing gown to wear over the provided operating gown.
Loose fitting cotton nightwear/pyjamas that are short sleeved and shorts.
Spare set of clothes and nappies (if applicable).
An overnight bag in case your child stays overnight.
Favourite cuddly toy/comforter to take to theatre; iPad/tablet, book or toy to keep your child entertained, as there may be some time to wait before their operation time.
Change for parking and refreshments.
Foods/snacks/formula milk for afterwards and bottle/beaker to drink from.

Day case or Inpatient

We specialise in many different children’s surgical procedures. Certain operations can be done as a day case procedure, meaning your child can go home on the same day. The decision as to whether your child can be a day case or inpatient will be discussed by your consultant and confirmed at your pre-operative appointment, determined by several criteria. However, it is advisable to bring an overnight bag for all children in case an overnight stay is needed. If your child stays overnight, they can have one adult staying with them. The length of stay will depend on your child’s needs, this can usually 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 the instructions, it will result in their operation being cancelled. Please encourage your child to sip their drink until you arrive at hospital. Children can have clear fluids (water or dilute squash, but not fizzy drinks, milk or fresh fruit juice) up-to one hour before an anaesthetic. Please wake your child to enable them to have a light breakfast (e.g. toast or cereal) if they are coming for an afternoon operation, but we do not recommend waking them up at night to eat, when they are coming in on a morning list.

Fasting information
Babies under 1 year	Breast fed	3 hours before arrival
Babies under 1 year	Formula Milk fed	4 hours before arrival
Babies under 1 year	Solids (if weaned)	6 hours before arrival
Children Morning operation	Usual teatime meal. No food after 2am	Clear fluids up until arrival
Children Afternoon operation	Light breakfast. No food after 07:30am	Clear fluids up until arrival

Before the operation

A safety check list will be completed, a name band put on, your child will be weighed, measured and have their heart rate, oxygen levels, temperature recorded, and numbing ‘magic cream’ applied to the back of hands. The nurses ensure that your child is ready to go to theatre. They will be asked to wear an operating gown or their pyjamas. Jewellery, make-up, false nails, eye lashes and nail vanish cannot be worn.

Meeting the Anaesthetist

A general anaesthetic ensures that your child is unconscious and pain free during their operation/procedure. They will be cared for by an anaesthetist who is a specialist doctor responsible for the care and well-being of your child throughout their operation. The anaesthetist will also ensure your child is comfortable.

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. The 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 do not 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 after they have woken and before they go home.

The anaesthetist will discuss your child’s anaesthetic and pain relief options. They will be able to answer any further questions you may have and will confirm your consent for the anaesthetic.

How will my child be anaesthetised (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 will depend on several factors such as age and medical history. The two anaesthetic methods are:

Anaesthetic gas induction

The anaesthetist will use a face mask to give anaesthetic gases which can smell like felt-tip pens. It may take a minute or so for your child to become anaesthetised and they may become wriggly, restless and resist 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

This is a quicker method of going to sleep. The anaesthetist will clean the cream from your child’s hand and whilst they are distracted (playing on an iPad) place the cannula and administer anaesthetic medicine through it. Children having an intravenous induction are usually asleep within a few seconds.

There are information leaflets:

Your Child’s General Anaesthetic

Common events and risks for children and young people having a general anaesthetic PDF

Pre-medications

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

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. Your anaesthetist will be responsible for deciding which medicines are most appropriate. Please ensure you have paracetamol and ibuprofen available at home for your child post-operatively (unless contra-indicated or allergic) as they are very effective.

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
Patient Controlled Analgesia (PCA), 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 infusion of local anaesthetic around the spine (started whilst asleep) and may be in place for a few days.
Caudal, a single injection of local anaesthetic around the nerves as they leave the spine, like an epidural (administered whilst asleep)

Meeting the Surgeon

The surgeon will discuss the procedure with you and your child, and they will be able to answer any questions you may have. They will need consent before proceeding and you or the person with parental responsibility will be asked to sign a consent form. It is important to involve your child in shared decision making, enabling them to make choices about their healthcare. Even when they are not able to make decisions on their own, it has benefits including empowerment, increased knowledge and confidence, increased compliance, improved self-esteem and encourages independence.

On some occasions older children 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. Young people, over 16 years old, will consent themselves, unless they do not have capacity.

Waiting

Before your child is collected for their anaesthetic and operation there will probably be some waiting time. Please encourage them to play with the things you have brought with you for distraction until it is their turn.

Going into 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. In most cases one parent/carer will be allowed to accompany the child to theatre if they and the child wish to do so. However, in certain situations this is not possible. Please support your child by reassuring them and engaging their interest in the distraction activity

e.g., playing on the iPad. As your child becomes sleepy expect to leave the room promptly, you will be taken back to the parents’ waiting room. If you wish to, you can leave the area maybe for a walk outside or some refreshments. The waiting area 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, so it may be a little while until we bring you to see your child, but they are being well cared for. It is not unusual for children to wake up disorientated. Please do not 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 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 vary between procedures. If your child is staying overnight, we will transfer you up to the ward as soon as it is appropriate.

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 nursery/school/work for at least 24 hours, during which they must have close adult supervision. The side effects of an anaesthetic can last up to 48 hours. Some operations will require your child to stay off nursery/school/work for longer, this may be to prevent infection and allow time for healing. This may have been discussed with you when you saw the surgeon and can be confirmed at your pre-operative assessment or with the surgeon.

We look forward to seeing you and your child soon