Before, During and After Surgery

Before Surgery

Arrival and check-in

Patients must arrive at CHOC two hours before surgery is scheduled to begin. Caregivers should park at the main entrance of the hospital at the valet stand. The valet stand opens at 5:15 a.m.. The valet parking cost is $2 and is valid only for the car carrying the child that is having the procedure. Please see our map and directions for more details.

From the main entrance, patients and their caregivers walk in to the main lobby to the welcome desk and receive a badge from the admitting representatives. At the elevators just beyond the welcome desk, proceed to the third floor and exit the elevators to the left. Once in the Tidwell Procedure Center lobby, patients are checked in to the hospital and registered with admitting. Once registration is complete, an associate from the admitting department will escort the patient and family to the child’s assigned room in the preoperative unit. The preoperative unit is where patients are prepared for surgery. The term “preoperative” may also be referred to as “pre-op.”

Preoperative Unit and surgery preparation

Once settled in the preoperative room, the pre-op nurse will confirm the child’s planned procedure and the time he or she stopped eating and drinking.  It is very important that patients and their families are honest and accurate with this information, as eating or drinking prior to surgery can have very serious consequences. The nurse will review the patient’s health history, allergies, home medications and any other information gathered in during the pre-op phone call. The nurse will also discuss what to expect for the rest of the day at CHOC and coordinate with the child life specialist who works with patients to help them feel more comfortable and less anxious about their procedures. Learn more about the child life specialists in the Tidwell Procedure Center. 

After the nurse is finished, the surgeon and anesthesiologist will meet with the patient and family. This is a good time for caregivers and patients to discuss any questions or concerns, including the expected length of the surgery or procedure or the after effects of anesthesia. There are no “dumb” questions and patients and caregivers are encouraged to discuss anything they do not understand or need clarified.

Depending on the child’s age and planned surgery or procedure, we may start an IV in the pre-op unit. This is a small straw inserted into your child’s vein to deliver medication during his or her time in the hospital. We use a numbing medicine that reduces the discomfort of the IV insertion. Our child life specialist will provide age appropriate distractions such as books, games, bubbles and lights to aid in the IV insertion process.  Learn more about the IV with this informative video.

Just before going into the operating room, the operating room nurse will check to make sure that all the patient’s and family’s questions have been answered and that the surgery team has all of the information needed to safely perform the child’s surgery or procedure. Once this is complete and the patient’s parent or legal guardian has signed all of the necessary forms, the parent or legal guardian will accompany the child to the doors of the operating room where they will give one another a hug and kiss.

During surgery

While in surgery, patients are cared for by a dedicated team of specialists who are specifically trained in pediatric surgery. These people include specially trained technicians who make sure that the surgeon has all of the equipment he or she needs for the child’s surgery or procedure, an operating room nurse who may assist the surgeon, an anesthesiologist whose job it is to make sure the child is safe and comfortable during surgery, and the surgeon.  Read more about the associates our patients and families meet on the day of surgery.

Once in surgery, legal guardians (parents) are escorted to the Tidwell Procedure Center lobby. Each patient may have up to four visitors, including legal guardians in the lobby area. The surgeon will let the patient’s family know how long the procedure should take and will expect to be able to speak with the patient’s caregivers when the surgery is over back in the Tidwell Procedure Center lobby.

During the procedure, family members can watch television and keep up-to-date on the patient’s progress using our patient tracking system or with the help of a family liaison. The patient tracking system allows families to stay updated with real-time information on the child’s progress through surgery and recovery on a monitor in the lobby. Family liaisons help families stay informed by communicating with staff on behalf of the family and providing resources like directions to local amenities and much more. The liaisons are an invaluable resource in helping families feel more comfortable and less anxious about the entire surgery process.

Many procedures can take hours and during that time, guardians may want to take a well-deserved break and get something to eat or drink in the cafeteria. Before leaving the Tidwell Procedure Center, legal guardians should let the front desk or the family liaison know so that we may provide a pager in the case we need to be in contact during the procedure.

After Surgery


After the surgery is completed, the patient’s surgeon will speak with the child’s caregivers in the Tidwell Procedure Center lobby. It may take an additional 20 to 30 minutes before the child reaches the recovery room, the Glass Slipper Guild Post Anesthesia Care Unit (PACU). During this time, the anesthesiologist begins the process of waking the child up from anesthesia, the child is moved from the operating room table to a bed, and is taken to the PACU and stabilized.

Once the patient is stabilized, the child’s legal guardians are escorted to the PACU. All other visitors must wait to see the child until he or she is admitted to an inpatient room in the hospital to spend the night or discharged home.

When patients are recovering from surgery—whether they are in the PACU or back in the preoperative unit—it is natural to want to wake the child to see how they are feeling. It is very important that patients get as much rest as possible after their procedure. Not only will the rest help the patient’s body heal faster, but it allows pain medication the time it needs to take effect. Our nurses and physicians closely monitor all patients and will wake them when it is necessary. Surgery and the effects of anesthesia can be very overwhelming. Patients’ family and friends need to make sure to keep the environment calm with as few visitors, noises and distractions as possible.

Pain and complications after surgery

Every caregiver worries about their child’s pain after surgery and depending upon the age of the child it may be difficult to know how much pain the child is experiencing. As pediatric specialists, however, we know the signs to look for in children when it comes to pain. We will also look to the child’s family since they are truly the experts when it comes to the patient and may pick up on behaviors or emotions not normal to the child. Working together, there are a variety of ways to help patients handle discomforts, complications and pains associated with surgery.  Learn more about pain management after surgery.

Patient discharge

After surgery, patients are taken to the recovery unit and from there they are sent to the inpatient unit to stay overnight in the hospital or  are discharged home. This depends upon the type of surgery and the child’s condition. Some children, depending upon the type of surgery, may go to an intensive care unit. If a child needs to go to the intensive care unit after surgery, this is typically decided upon and discussed prior to the child’s surgery.

Children who require an overnight stay will go from the recovery room (PACU) to one of our inpatient units. Parents or guardians will remain with the child as they are transported to the inpatient unit. All other visitors may wait in the hospital’s main lobby and will be notified when visitors are allowed in the inpatient unit.

Children who are admitted after surgery can receive additional assistance from our child life specialists as they recovery from their procedures. Education, support, bedside activities and playroom opportunities will be available during their stay.

If the patient is going home the same day, he or she will be discharged home after adequately recovering from anesthesia. When awake, the patient will be allowed to drink fluids and have a light snack. The child’s nurse will go over the patient’s discharge plans.  Learn more about these plans and what to expect once home with the child in our After Surgery Guide.