Preparing For Surgery

Our goal is to provide a family-centered environment of care by keeping you informed at each step in your child's care, from pre-operative evaluation through discharge. As you and your child prepare for surgery, please use the information below as your guide. If you have any questions, please call us at 682-885-4022.

Starting April 24, Cook Children's Pediatric Surgery and Trauma will serve you in an improved area at the Dodson Specialty Clinics. Please use the new P1 garage to park and check in at the new location of Dodson Central Registration. If you have any questions, just ask us. We're here for you every step! Download map.

Sometimes things get complicated. Following the steps in the Cook Children's surgery guide will help things go more smoothly. Feel free to print a copy for your convenience.

Download Surgery Guide (PDF) Download 10 Things to Know (PDF)

Surgery Guide

Step 1: Preregistration

Preregistering

You must preregister your child for surgery. For your convenience, there are two ways to preregister:

By calling our registration phone at 682-885-2965, Monday-Friday, 8:30 a.m.-4:45 p.m.

After you preregister

After you preregister, we'll call you to answer any questions you may have about:

Your child's health insurance
Any copays that may be due prior to your child's surgery
Cook Children's billing

Guardianship

If you're not the parent of the child having surgery, we must have a copy of your legal guardianship document before we can register your child for surgery.

Step 2: Planning for surgery

Planning ahead can help to make your child's surgery and stay at Cook Children's medical center much less stressful.

Your schedule

If you work, please plan to take the day off.
Your child needs your full attention on the day of surgery.
You'll stay with your child until it's time for them to go into surgery

Your child's visitors

Please don't bring other children to the medical center on the day of surgery.
One adult visitor may stay in the pre-op room with you after your child gets ready.
We limit the number of visitors in the post-anesthesia area to only two adults.

Arriving and leaving

Please make driving plans for getting to and from the hospital.
We'll contact you to let you know what time to arrive.
Recovery time is different for each child so we can't tell you the exact time that you'll be able to leave.
Please make sure your ride home can be flexible.

Things to have at home for your child after surgery

Prescription medicines (if your doctor gave you a prescription to fill).
Popsicles™
Apple Juice
7-Up™ or Sprite™
Soup
Jell-O™, pudding, ice cream

Step 3: Preparing for surgery

Talking to your child before surgery

This is one of the most important things you can do. Surgery can be scary.
Learn as much as you can about the surgery, this will help you talk to your child with confidence.
Tell your child what they'll see and hear.
Use words they can understand.

Pre-op tours

This is the best way to prepare your child and family for surgery.
A Child Life specialist will show you the pre-op area and explain what to expect on the day of surgery.
Please call to make a tour appointment for your child and family during the week before the scheduled surgery.

If you aren't able to attend a pre-op tour at the medical center, please watch our pre-op video here.

Helpful pre-op tools

Surgery coloring book

Step 4: Pre-op visit or phone call

We may schedule a time for you and your child to come to the medical center for a pre-op visit with anesthesia. If you don't have a scheduled pre-op visit, we'll call you several days before surgery.

Information we'll need for the pre-op visit or phone interview

Medicines
- A list of your child's current medications, if any
- Doses and times
- Please be sure to ask us when to give the last dose of your child's current medicines
Allergies
- Foods
- Medicines
- Others such as latex, dyes, etc.
Medical history
- History of past surgeries/procedures
- Any recent illness
Paperwork
- Information other doctors gave you for this surgery
Child's special needs
- Example: hearing aid, developmental delay, autism, etc.

Call us during the week before surgery at 682-885-4022 if:

You've missed our calls. We'll leave you a message to call us back.
You need to reschedule the surgery
Your child becomes sick (upper respiratory symptoms such as coughing, congestion, fever, runny nose, sore throat or problems breathing).
You'd like to schedule a pre-op tour
You have any questions or concerns

Step 5: A very important phone call

On the day before surgery, we'll call you between noon and 6 p.m. with important information about your child's surgery.

Please keep your phone with you.
If we miss you, please call us back as soon as possible at 682-885-4022.
Please write down:
- Time to stop eating/drinking.
- Time to arrive at the medical center.

Step 6: When to stop eating and drinking

Your child's stomach must be empty for surgery. Food or fluid in the stomach during surgery can cause serious health problems. Please make sure that your child doesn't eat or drink after the STOP times.

You'll be given stop times for each of the following:

STOP solid foods and milk
STOP formula and bottles
STOP breast milk
STOP clear liquids (water, Gatorade™, apple juice, Pedialyte™. etc.)

For your convenience, we've also provided a downloadable, printable form so you can write down STOP time and day. You may want to place the chart where other family and caregivers can see it.

You can download the STOP chart here.

After STOP times, please watch your child closely.

Make sure your child can't reach any foods or fluids
Check the bedrooms, play areas and especially the area around your child's car seat for any food or liquids your child might be able to reach
Please don't allow anyone to eat or drink in front of your child after the STOP times.

Your anesthesia nurse should tell you what medicines you can give your child before surgery and if and when you should stop any medicines before surgery. If you are unsure about STOP times for your child's medicines, please contact us at 682-885-4022.

Step 7: When and where to arrive

When we call you the day before surgery, we'll also tell you what time you need to arrive at Cook Children's and where you need to go.

If your child's surgery is at the medical center, you'll go to 801 7th Avenue. You may park in the 7th Avenue garage or you may use our drop-off/valet location at the main entrance to the medical center. Valet parking is FREE for surgery patients and opens at 5:30 a.m. If your arrival time is scheduled before then, you'll need to park in the garage.

If your child's surgery is at the Dodson surgery center, you'll go to 1500 Cooper St. You may park in the 7th Avenue garage or you may use our drop-off/valet location at the Dodson lower level entrance. Valet parking is FREE for surgery patients and opens at 5:30 a.m. If your arrival time is scheduled before then, you'll need to park in the garage.

Any additional family members arriving in separate cars may park in the 7th Avenue garage or they may valet park after 5:30 a.m. for $5.

Download Arrival Time Sheet Campus and Parking Map

Step 8: Evening before surgery

We've provided a checklist of important things that need to be done the evening before surgery to assure that things go more smoothly on surgery day. For your convenience, you may also download and print the checklist here.

Bath and hair
- Wash your child with anti-bacterial soap.
- Remove all hair pins, ribbons, bands, clips, etc.
- Don't apply make-up, lotions or baby powder.
- Remove temporary tattoos and nail polish (fingers and toes).
- Follow any special instructions you may have been given for bathing or cleaning (example: CHG wipes). Call your surgeon's office for more information.
Jewelry
- Remove all jewelry and leave it at home (earrings, piercings, necklaces, etc.).
Food/Fluids
- Follow the step 6 STOP times.
Medicines
- Give usual medicines unless told otherwise.
- Have surgery prescription medicines if ordered.
Pack bag for your child
- One comfort item (toy, blanket, pacifier, music, etc.).
- Empty bottle or sippy cup (hide from child).
- Extra underwear.
- Home medical supplies.
Pack a bag for you
- Sweater or light jacket.
- Book, magazine, etc.
- Cell phone charger.
Car Seat
- Make sure car seat is the right one for your child's age and height.
- Please call Cook Children's Trauma Services if you have any car seat questions: 682-885-3954.

Step 9: Morning of surgery

We've provided a checklist of important things that need to be done in order to assure that things go more smoothly on surgery day. For your convenience, you may also download and print the checklist here.

Food/fluids
- Follow the STOP time directions you were given.
- Don't let your child eat or drink after the STOP time.
- Watch your child closely to make sure he or she doesn't sneak any food or fluids.
Clothing
- Dress your child in comfortable clothes (pajamas are perfect).
Medicines
- Only give medicines we've approved.

Before leaving home

Please make sure you have the following items before you leave home:
- Your driver's license or photo ID.
- Your insurance information.
- Legal guardianship papers if you're not the parent of the child having surgery.
- Map and directions to the medical center. You can also access driving directions here and a campus map here.

Checking in for surgery

Checking in at Cook Children's Medical Center

If you had a pre-op telephone interview:
- Go to medical center patient registration on the first floor by Starbucks™.
If you had a pre-op visit:
- Go directly to medical center outpatient surgery area on second floor.

Checking in at the Dodson Surgery Center

If you had a pre-op visit or telephone interview:
- Go directly to Dodson Surgery Center lower level

Campus Surgery Check-in Locations

Surgery

Pre-op area

Only two adults allowed in this area.
No food or drinks

Getting ready for surgery

Our questions
We'll ask the same questions several times. this is to make sure that we all agree and will help us all keep your child safe.
- Tell me your child's name.
- What body part are we operating on?
ID bracelets
- Check spelling of your child's name.
- Check your child's birth date.
- Tell us if there is a mistake.
- Tell us if the bracelet comes off.
Parents – cell phones and cameras
- Please silence your cell phone while your child is getting ready.
- For the privacy of others, please don't take photos or videos in the pre-op area.

Safety while waiting for surgery

Please don't let your child climb or sit alone on an exam table or bed.
We may give medicine to help your child relax.
After we give the medicine, your child must stay in the bed with the rails up
Hold infants and toddlers securely in your lap to prevent falling

While your child is having surgery

Staff will direct you to the family waiting area.
Seating is limited. Extra family members may sometimes be asked to wait in another area.
A parent or guardian must stay in the waiting room during surgery.

After surgery recovery

After surgery your child will taken to the recovery area, sometimes called PACU (Post Anesthesia Care Unit). Your child's surgeon will also speak with you after surgery.

Phase one recovery

We'll move your child from the operating room to phase one recovery
- Your child is still asleep
- A nurse is at your child's bedside at all times
No family members are allowed in this area

Phase two recovery

Parents

Only two adults are allowed at the bedside.
We'll be close by if you need anything.
Please turn off your cell phone. Your child will need your full attention.

Waking up

At this time your child may seem sleepy, confused or fussy.

flushed cheeks

Your child may have pink cheeks or warm puffy skin. This is normal and should go away in a few hours.

The IV will remain in place until discharge so we can give medicine if needed.

Pain and nausea medicine

We'll do everything we can to ease any pain your child may have. We'll give pain and/or nausea medicine if needed.

Drinking fluids

We'll begin offering small amounts of clear liquids. Please help us by encouraging your child to eat a Popsicle® or drink some fluids.

Going home and Teach Back

Before you go home we'll give you a surgery discharge teaching sheet. We'll explain:

What you need to know about taking care of your child after surgery.
What you need to do (for example, if your child runs a fever, throws up, has pain, etc.).
Why doing this is important.

We have a special way of teaching our patients and families at Cook Children's. We call it Teach Back. Everyone needs help understanding health information. You aren't alone if you find things confusing at times. Please, always ask questions and tell us if you don't understand our answers. Teach Back includes the following:

Sometimes we may ask you to pretend you are home and that we are a family member or neighbor.
We'll ask you to show us or tell us how to care for your child at home after surgery
For example: "What should I do if my child has fever?"

Teach Back helps us make sure that we are teaching this information in a way that makes sense.

Billing

Cook Children's will bill your insurance company, if applicable, for your child's surgery.

You'll also be billed separately by one or more physicians who care for your child. This might include radiologists, pathologists, anesthesiologists or surgeons.

For any questions relating to your account or to request an itemized statement, please call Patient Accounting at 682-885-4432. For families outside area codes 817 or 682, the toll free number is 1-888-852-6635.

If you have questions about your insurance, please read your insurance card, policy or other material from your insurance provider to find a phone number to call for information. If your employer provides insurance, you may also call your employer's benefits office for assistance.

Helpful things to know

10 things to know about surgery

We know the medical center is really big, and there's a lot going on. Most parents eventually say they wish they'd known some of the basic things when they first arrived. So, parents on the Cook Children's Family Advisory Council put together a list of those things from their experiences. Here are the tips they've learned along the way:

Cook Children's retail pharmacy
Cook Children’s has a retail pharmacy on the first floor, next to the Emergency Department. You can have your child’s medicines filled at the pharmacy or delivered to you in the waiting room. If you’d like to pick them up before you leave, let your nurse know as soon as possible. The pharmacy’s phone number is 682-885-6913. You can pick up and pay for your child's medicines before you leave the medical center.
Child Life specialists offer support
In addition to providing play activities, a Child Life specialist can also:
- Prepare and support you and your child for procedures.
- Talk with patients and siblings about diagnoses, treatment and other changes.
- Help celebrate birthdays and other important life events.
Social workers are here to help
You can ask to talk with a social worker for help with:
- Job, lodging and child care issues.
- Medical insurance and/or other financial concerns.
- Problem-solving, community resources and crisis intervention.
Surgical procedure follow-up
Within 30 days following your child’s surgical procedure, a Cook Children’s staff member will call and check on your child. Cook Children’s takes part in a national program that measures the quality of patient care and outcomes. The information provided by parents helps Cook Children’s.
Actual time in surgery
Your surgeon will tell you how long your child's surgery will take, but please remember the time required both before and after the surgery. Both of these phases take time and are important stages of the process. Don’t be alarmed if the time in surgery is longer than discussed.
There is a chapel
There is a small chapel on the second floor by the elevators. The chapel is open 24 hours a day and Catholic masses are held Fridays at noon. Chaplains are also available by calling 682-885-4030.
There are lots of checks and balances
The surgical staff will ask you several times about your child’s surgical procedure, history and medications. This is done so the staff feels confident that the parents have a good understanding of the surgery being performed and that all members of the team agree. Also, many checks are in place to ensure nothing in your child’s history or medication list have been missed or left out.
You know your child best
Share your concerns with the surgery staff and surgeon. If you don't feel like you're being heard, ask to see the nurse manager or call a patient representative at 682-885-6698.
Keep a notebook
Download our FREE health care notebook to write down questions and information about your child's care, keep track of doctors appointments, medications and more. Health care notebooks are also available for free from the Family Health Library. Just stop by, call 682-885-3060 or email family.library@cookchildrens.org.
Surgery tours are available
You can schedule a tour prior to your child’s surgery. To schedule a tour, call 682-885-7200.

Thank you

Thank you for trusting Cook Children's as a partner in your child's surgery.

We encourage you to be involved in your child's care. You know your child best and we encourage you to share your past experiences and what works best for your child. We want you and your child to be as comfortable as possible, so please let us know if there is anything we can do to help make your experience more comfortable.

We're here to help.

If your child requires surgery, you probably have lots of questions. We can help. If you would like to speak to our staff, please call our offices at 682-885-7080.