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The normal routine for
patient can seem exhausting. The
nursing staff in the Same Day Surgery unit endeavor to make the process as
painless as possible.
The following is long but detailed.
Surprise...
your doctor tells you that you are having surgery.
Now what is going to happen?
Depending on type of surgery, your surgeon
will schedule you as soon as they can when there is an opening in the
Operating Room. Your surgeon
will then send you to Same Day Surgery (SDS) to schedule a preoperative
appointment.
You will also need to stop by hospital admissions.
On the day of your appointment you will meet the SDS nurses who will
go through all the paperwork and give you specific instruction for your
type of surgery. You may get
blood drawn for laboratory tests or an EKG.
The nurses may also send you for X-rays or to physical therapy
depending on your surgery and what your surgeon ordered.
After you see the nurses someone from Anesthesia will see you.
The provider will review your history again, your EKG, and other
health care information. The
provider will then discuss with you the different types of anesthesia that
are available to you depending on your surgery and current health.
Sometimes you may not have very much of a choice, but most of the
time you have a lot of input in how things go.
You will receive instructions on what you can and can not eat or
drink. You will also receive instructions on what medications Anesthesia
will want you to take or which ones they don't want you to take.
If your surgeon has given you instructions already, please share this
information with the Anesthesia provider.
The day before surgery you will call SDS and
get your arrival time for surgery. We
have you arrive early because sometimes cases get canceled and we can get
you into surgery early. When
you arrive you will probably wait a little while in the waiting room,
until a bed is available in the holding area.
One family member, not a child, is allowed to be with you in the
holding area. In the holding
area you will remove your clothes and put on a gown.
The nurses will also ensure you remove all jewelry (IT IS BEST IF
YOU LEAVE YOUR JEWELRY and valuables AT HOME).
If you have a wedding ring that won't come off let the nurses know.
We can usually cover it up to prevent a potential electrical burn.
We do not want you to cut off your wedding ring.
ABSOLUTELY
NO PIERCINGS may be left in.
The SDS nurses will once again check the paperwork, verify your
identity and procedure then start an IV.
For older children (not 20 years-old) we have cream that
numbs the skin. For younger
children, we usually put them to sleep and start the IV after they are
asleep and comfortable. Your
surgeon will come by and verify your identity and procedure then mark your
skin close to where they will be making an incision.
After that your Anesthesia provider and Operating Room nurse will
also verify your identity, procedure and the mark that the surgeon made.
Once the Operating Room is ready for you the Anesthesia provider
will come and get you. They
may start antibiotics or give you medicine to relax you.
Most people do not remember anything past the relaxing medicine.
If you are getting a Regional Block, you will be taken to a special
room where the Anesthesia providers will place the block, while you are sedated.
Then you will go to the Operating Room.
Once in the Operating Room, we will assist you getting onto the
Operating Room table from your gurney since you will most likely be sleepy
from the relaxing medicine. If
you remember anything you will probably remember it is cold and the lights
are bright. You will have all
sorts of monitors placed on you so your Anesthesia provider can monitor
your EKG, blood pressure, oxygen in your blood, temperature... all your
vital signs. You will probably
be given oxygen to breath through a mask.
If you are having General Anesthesia, you will then be given more
medicine through your IV and you will fall completely asleep.
Your Anesthesia provider will then place a breathing tube or mask
in your airway to help you breath during surgery.
You will not feel the tube going in or be aware of anything at this
point in time. Your brain will
be in the
Bahamas
, on the beach having a good time. Once
your airway is secured your Anesthesia provider then starts giving you
medicine through your IV or in the gases you are breathing to keep you
asleep. Then your surgeon does
their thing. When they are
done, we wake you up. Once you
can breathe for yourself and your protective reflexes are intact we remove
the artificial airway/breathing tube.
Your brain is still in the
Bahamas
at this point.
We then take you to the Recovery Room where you finish waking up and
your brain "comes to". Then
once you are more awake you can then go to the Phase II of recovery then
home. Or you will be sent to
the ward where you spend the night in the hospital.
This depends on your surgery and your health.
Sometimes due to complications, like nausea or pain, patients who
intended on going home stay the night in the hospital until they are more
ready to return home. You
should wake up fairly comfortable and the nurses in the Recovery
Room/Phase II continue to give you more pain medications as you wake up
more and more. Some people
perk right up quickly and seem to skip out the door.
Others take longer to recover from their anesthetic/side affects
like nausea, or to control their pain.
If you are feeling pain or other unpleasant sensations let your
nurse know. You will be asked
quite frequently. We want to
know and want you to be as comfortable as possible.
If you are having Regional anesthesia, you may be sedated through
the procedure to make the time more comfortable.
In some cases you may be allowed to be more awake and aware.
Sometime, especially in arthroscopic procedures of the extremities,
you may be able to watch the surgery on the TV screen.
Either way, you will not be completely asleep, and you may remember
periods of time. General
Anesthesia is always our back up plan in case the block wears off or is
not completely effective. In
the event your block is not completely effective we find this out prior to
incision by testing the sensation. We
will not proceed until you are either completely numb, or completely
asleep.
The Recovery Room procedure is mostly the same for Regional
Anesthesia except in the event of spinal anesthesia where we want the
block to wear off before you can proceed on.
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