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Cardiac surgical preadmission fact sheet

Cardiac surgical preadmission

Preadmission clinic

Prior to your child’s admission, you may be advised to attend a preadmission appointment. These are organised when your child is being admitted for surgical procedures, cardiac catheterisation, electrophysiology studies and investigations under anaesthesia. These appointments are arranged in conjunction with the relevant care coordinator in the outpatient setting. Preadmission appointments are an important step in the course of your child’s procedure and recovery.

The preadmission process

Your preadmission appointment allows the cardiac team to assess your child’s health status in preparation for their procedure and anaesthetic, and for you to ask any questions. This is important for parents and children to ensure a smooth transition throughout the hospital admission. The preadmission session takes a number of hours and this may cover topics including:

  • fasting process
  • hygiene and clothing preparation
  • procedure education
  • procedural consent
  • orientation to the hospital’s facilities
  • discharge education
  • occupational therapy review
  • physiotherapy review

Oral health clearance

If advised by the relevant care coordinator and/or your doctor, your child will need an oral health clearance prior to their procedure. If your child has visited a dentist in the past 12 months, your attending dentist will need to supply a letter clearly stating that your child is orally fit for surgery. Please ask our staff for a template of the letter your child’s dentist can use.

Instructions will be provided to you to give to your dentist regarding the completion of your child’s oral health clearance letter.

Education and support tools

A variety of education and support tools have been devised to familiarise you and your child with the hospital environment and process.

These include:

  • preadmission phone calls from care coordinators
  • pain assessment tools
  • equipment demonstrations
  • photographic education folders
  • story books
  • psychology and occupational therapy involvement.

When you attend preadmission

We recommend that two adults attend preadmission. A lot of information is provided at the meeting and if two adults are present, it supports better understanding. An extra pair of hands to supervise the patient and siblings (if present) is also helpful.

What to bring

The appointment can be quite long, please bring supplies including food, fluids, nappies and toys.

Be aware of any medication your child is on and the dosage. Some medications may need to be stopped prior to admission (i.e. anticoagulants like aspirin and warfarin and anti-arrhythmics like flecanide).

Your child’s care coordinator will contact you and advise you of any medication changes prior to the procedure or surgery.

Tests

A variety of tests may be performed in preadmission clinic. These include X-ray, echocardiogram, weight, height, blood pressure, oxygen saturations, ECG and blood testing. Blood tests are required in the majority of cases before the surgery or procedure can take place.

Discussing blood testing with your child prior to your appointment is an individual decision and dependant on your child’s age and nature. Local anaesthetic cream can be applied up to one hour prior to blood taking. It is protocol for girls over the age of 12 years to have a urine pregnancy test due to X-rays that are used throughout your surgical stay.

Time with the care coordinator

You will see the relevant cardiac care coordinator who will discuss the surgical process/procedure and your child’s hospital stay with you. The care coordinator will help you prepare for the surgery/ procedure (which is usually the next day). They will make sure all tests needed are done prior to the surgery/ procedure and give you all the information you will need to be prepare.

Consent is normally obtained at your surgical review or at your doctor’s appointment or preadmission for catheterization and EPS. Anaesthetic consent is normally obtained by the anaesthetist the morning of surgery. The consent involves the medical staff outlining the procedure to be performed, desired outcomes, risks, complications and discharge management.

Fasting

Before surgery, your child will have to fast, which means not eating or drinking for a certain amount of time. It is essential for anyone having surgery to have an empty stomach so that there is no risk of vomit or food going into the lungs.

It is very important to follow fasting times as procedures and surgeries may be cancelled if the times are not followed. For babies under the age of 12 months on formula or breast milk, four hours is usual. They are encouraged to have a limited amount of water or apple juice until two hours before surgery.

Children over the age of 12 months who have solids, milks or other fluids, will need to fast for six hours and are encouraged to have a limited amount of water or apple juice until two hours prior to surgery.

These times may change at the discretion of the anaesthetist. Your care coordinator will fill in a fasting sheet for you to take with you.

Surgical consent

You will meet your child’s cardiac surgeon at a surgical review appointment or they will talk to you over the phone for your surgical review if you live in regional Queensland. At this time the surgeon will explain the operation, answer any questions you may have or draw a diagram to illustrate the procedure. A date for the procedure may be made at this appointment, or you may choose to  consider what date suits your schedule. If your child is an inpatient, you will see the surgeon prior to surgery.

The surgeon will ask you to sign a consent form for your child’s surgery once all aspects are explained to you and all your questions have been answered.

Cancellations

Unavoidable circumstances may result in your child’s procedure being cancelled and rescheduled. If this occurs you will be notified by either booking staff or the care coordinator prior to the event. We apologise for the immeasurable stress this can cause you and your family.

If your child is unwell prior to the scheduled procedure please contact the care coordinator. You may be asked to see your GP for immediate assessment of your child. Children with acute illness won’t tolerate anaesthesia or surgery and the procedure will need to be rescheduled.

Contact us

If you still have any questions or concerns after the appointment, please contact the relevant care coordinator.

Queensland Paediatric Cardiac Service
Lady Cilento Children’s Hospital
501 Stanley Street, South Brisbane
t: 07 3068 2790
t: 07 3068 1111 (general enquiries)

In an emergency, always call 000.

If it’s not an emergency but you have any concerns, contact 13 Health (13 43 2584). Qualified staff will give you advice on who to talk to and how quickly you should do it. You can phone 24 hours a day, seven days a week.

Resource No: FS059. Developed by Queensland Paediatric Cardiac Service. Updated: February 2015. All information contained in this sheet has been supplied by qualified professionals as a guideline for care only. Seek medical advice, as appropriate, for concerns regarding your child’s health.

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