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Pre-Operative Assessment Clinic For Information Call (613) 721-2000 ext. 2920 Between 3:00 and 4:00 p.m. Mondays to Fridays except Holidays Your safety and complete recovery is our priority following your surgery. For this reason, we ask you to follow these instructions. ADMISSION You will be admitted to the hospital at least one day before your surgery. Your admission date is: _______________________ Report to the admitting department and bring your HEALTH CARD AND ALL YOUR MEDICATIONS, INCLUDING INHALERS, CREAMS, HERBAL PRODUCTS, VITAMINS, EYE DROPS WITH YOU. You will be told of your time of surgery on admission. Your date of surgery is: _______________________ Before you come to the hospital on the day of your admission, you may have your usual meals and medications, unless otherwise instructed. Before your admission day, if you develop a cold, or other illness or have an infection, please notify your Surgeon. 2 PRE-OPERATIVE INSTRUCTIONS 1. If you are a smoker, refrain from smoking 24 hours before surgery. Please ask your nurse if you would like information on nicotine replacement therapy. 2. Your Surgeon will order any medications you will require while in hospital. BRING ALL YOUR MEDICATIONS WITH YOU, INCLUDING EYE DROPS, HERBAL MEDICATION AND VITAMINS. You may be advised to hold some medications before surgery: STOP: ________________________________________________________ ________________________________________________________ ________________________________________________________ 3. At least 7 days before surgery do not wax or shave the surgical area (to help prevent infection). If your surgical area requires a shave prep, this usually is done in the operating room. 4. Do not bring any valuables with you to the hospital (i.e. jewellery, credit cards, money). WE DO NOT ASSUME ANY RESPONSIBILITY FOR ANY LOST OR STOLEN ARTICLES. 5. Bring only your personal articles that you will need i.e. housecoat, slippers, comb, toothpaste, toothbrush, comb etc. These items are not supplied by the hospital. 6. The Anaesthetist may visit you before your surgery or any other specialist as seen necessary by your Surgeon. 7. Your Surgeon may order a laxative, suppository or enema to be given the day before your surgery to cleanse your bowel. Instructions:______________________________________________ ________________________________________________________ ________________________________________________________ ________________________________________________________ ________________________________________________________ _____________________________________________________ 8. Your nurse will ask you to shower or bathe prior to surgery. Take care to wash the area of the body to be operated on well. 3 9. The day of surgery, DO NOT wear make up, nail polish (fingers and toes), jewelry or cosmetics (creams/lotions). DO NOT WEAR ANY SCENTED PRODUCTS. This includes aftershave, cologne, perfume and deodorant. Many of our staff and patients have experienced severe reactions to these products. Remove any bobby pins from hair, all jewelry and body piercings before surgery. Contact lenses and dentures will be removed immediately prior to surgery. 10. To ensure your surgery is not cancelled, PLEASE FOLLOW THESE INSTRUCTIONS AFTER MIDNIGHT THE NIGHT BEFORE YOUR SURGERY: Do not eat any food Do not drink any liquids (including water) No candy, gum or lozenges Eating or drinking can cause you to vomit during anaesthesia and this can be dangerous. TO PREPARE FOR YOUR SURGERY, YOUR NURSE WILL: 1. Do your blood pressure, pulse, temperature and oxygen saturation level. 2. You will be asked to get into a hospital gown. 3. Your nurse will check to ensure your consent, and preparation for surgery has been completed. 4. If you have allergies make sure your nurse is aware as you must have an allergy band put on with your name band. 5. Your nurse may start an I.V. and give you I.V. antibiotics before surgery. The I.V. that the nurse has started allows the anaesthetist to give you some medication in the tubing in the Operating Room to put you to sleep. 6. A porter will take you to the Operating Room by stretcher or bed. 4 AFTER SURGERY (Post-Operative) 1. After your surgery you will go to the Recovery Room for monitoring about 30 minutes or longer. 2. The Nurse will check your blood pressure, pulse and operative site frequently. The nurse will change or reinforce your dressings as necessary. 3. You may have an oxygen mask on for a short time. 4. If you have any drains, tubes or a catheter, your nurse will check these frequently. 5. If you have pain or feel sick let your nurse know. You can be medicated for this. You may have a Patient Controlled Analgesic pump. This allows you to participate in your own pain management. SEE INFORMATION RE: PAIN PUMP AT BACK OF BOOKLET. 6. To enable the nurse to rate your pain, you will be asked to rate your pain on a scale from 0 – 10. 0 is no pain and 10 is the worse pain you have ever had. SEE INFORMATION RE: PAIN SCALE AT THE BACK OF BOOKLET. We recommend you take your pain medication as needed so you can get up and move as instructed by your Surgeon. 7. You will be drowsy after surgery, but as you are able, you will be encouraged to do deep breathing, coughing and leg exercises to help prevent complications. a) Leg Exercises Point your toes towards your head, then towards the foot of the bed. Make your feet go around in circles 5 times. This is done 4-5 times a day until you are walking. 5 b) Deep Breathing and Coughing Exercises Take a deep breath in through your nose and blow out through your mouth. Repeat this 3 times. On the third breath, cough 2 to 3 times. This is done every 2 hours for the first day and then every 4 hours for the next 1 to 2 days. 8. After recovery, you will be transferred to your room. Your family will be able to visit you after you are admitted to your room. They can bring in extra personal toiletries and clothing at this time. All patients and their families are asked to adhere to the visiting hours and limit two (2) visitors at a time – 11:30 a.m. to 2 p.m. and 4:00 p.m. to 8 p.m. Please limit visits from young children to immediate family only. If you have sleep apnea you are asked to bring in your CPAP machine and equipment the day of surgery. See information on Sleep Apnea at the end of this information package. DISCHARGE FROM THE HOSPITAL Discharge time is 10:00 hours. You must make your arrangements for your drive home before you are admitted to the Hospital. On discharge you will be given your prescriptions, instructions regarding your wound care, activity level, diet and follow-up visits with your Surgeon. Supplies needed on discharge Sterile 4” x 4” gauze pads Roll of surgical tape Sanitary pads Bandaids _____________________________ _____________________________ 6 Important Numbers: Queensway Carleton Hospital (613) 721-2000 Telehealth Ontario 1-866-797-0000 Emergency Medical Assistance 911 Your Surgeon’s Office Number _______________________ 7 9 Worst Possible Pain Very severe pain 7 8 What is a pain scale? A pain scale is a tool to measure how much pain you are having. Your Nurse will use the Pain scale to measure your pain. 10 PAIN SCALE Severe Pain Moderate Pain Mild Pain 1 How does the pain scale work? Your Nurse will ask you to rate your pain on A scale from 0 to 10; with 0 being no pain And 10 being the most severe pain you can imagine. 2 3 4 5 6 Why do we measure your pain? We measure your pain frequently after your surgery so that we can be sure your pain medication is working. 0 No 8 Pain PAIN MANAGEMENT Pain control is very important to your quick and speedy recovery. If you have a spinal anaesthetic, your Anaesthesiologist may decide to use a long acting pain medication. This medication is given during your surgery and can provide pain relief for up to 24 hours. If you receive this medication, your oxygen level and respiratory rate will be monitored for the first 24 hours. Patient Controlled Analgesia (P.C.A.) may be used with the long acting pain medication. The P.C.A. pump allows you to participate in your own pain management. The pain medication is delivered through a special pump that is connected to your intravenous and is controlled by a button that looks like a call bell. When you start to feel some discomfort, you simply push a button and receive a small dose of medication. This medication will start to work in just a few minutes. The P.C.A. will be discontinued on the second day after your surgery. Once the P.C.A. is discontinued, you can have pills for pain. If you are uncomfortable, ask your Nurse for them. If required, you will be discharged home with a prescription for medication to manage your pain. *** It is very important to take your pain medication for the first few days and be comfortable enough to move about as required. How long will I be using the P.C.A. pump? Most patients use the P.C.A. pump for up to 48 hours following surgery. Just remember that everyone wants you to be as comfortable as possible. Special things you should know while using the P.C.A. pump: DO NOT ask or permit family and friends to push the P.C.A. button for you. It is important that only YOU give yourself the medication when you feel you need it. The medication will be delivered right away and will start to work in a few minutes…please be patient, give it time to work. When it is time for the P.C.A. to be stopped you will be switched to pain pills. Ask your Nurse for something for pain when you need it. 9 PATIENT CONTROLLED ANALGESIA (P.C.A.) HERE ARE SOME FREQUENTLY ASKED QUESTIONS ABOUT P.C.A. (Adapted from pamphlet printed by Abbott Laboratories) When will P.C.A. therapy be started? The P.C.A. pump will be started in the Post Anaesthetic Care Unit and when you’re fully awake the Nurse will remind you how to use it. The pump will go to your room with you when you are ready to leave the recovery area. How much medication will I receive? The button may be pushed as often as required in order to make you comfortable enough so that you will be able to deep breath and move with minimal discomfort. Continue to give yourself more medication as needed to maintain this level of comfort once you have reached it. Can I give myself too much medication? No. The P.C.A. pump is designed so that you cannot give more medication than your Doctor thinks is right for you. What if I start to feel sleepy? The pain medication you’ll be receiving has that effect on many people. If you feel sleepy just decrease the number of times you push the P.C.A. button until you feel more awake again. What if I become uncomfortable? If your pain medication seems to stop working, even after pushing the button several times and giving the medication a few minutes to work, just call your Nurse to check the I.V. If you are still uncomfortable after the Nurse has checked the I.V., your Nurse will notify your Doctor and your dose will be adjusted as required. 10 WELCOME TO THE SURGICAL CARE ROOM (613) 721-2000 Ext. 3902 What is the Surgical Care Unit? The Surgical Care Unit is a mixed gender four-bed room on the surgical unit for patients requiring close observation after surgery. You may be admitted to his unit for one or two days. As you recover from surgery, you may be discharged home or transferred to another room. Will my family/friends be allowed to visit? Yes, your immediate family can visit and you are restricted to a maximum of two visitors at a time. These visits should be short, ten minutes at a time; so that you can get the rest you need to recover after your surgery. Your family can wait in the unit dayroom between short visits if necessary. What are the Surgical Care Unit visiting hours? Visiting Hours: Rest period is: Visiting Hours: Rest period is: Visiting Hours: 11:30 a.m. – 2:00 p.m. 2:00 p.m. – 4:00 p.m. 4:00 p.m. – 6:00 p.m. 6:00 p.m. – 7:00 p.m. 7:00 p.m. – 8:00 p.m. Will I have access to a television or telephone? Telephone and television are available for a fee; however incoming calls may be restricted to provide adequate rest required for recovery. May my family call the Surgical Care Unit? Yes. Your family may telephone the unit to inquire about your condition. However, in order to limit telephone calls, it is required that only one family member calls on behalf of the whole family. 11 Patient safety is very important to the Queensway Carleton Hospital and this information is provided to patients/families to help inform you of your essential role in your own safety. The information contained in this booklet is not specific medical advice, nor a substitute for medical advice. For your safety, it is advised that you speak with your doctor and healthcare team about your particular health care needs. Protect Yourself! Clean your hands frequently and ask your health care providers and visitors to do the same. Clean Hands Save Lives! 12 WELCOME TO THE OBSERVATION SLEEP APNEA ROOM (613) 721-2000 Ext. 3902 What is the Observation Sleep Apnea Room? The Observation Sleep Apnea Room is a mixed gender four-bed room on the surgical unit for patients requiring close observation who are diagnosed with obstructive sleep apnea or have risk factors for sleep apnea. You may be admitted to this unit for four to twenty-four hours after your surgery for continuous oxygen monitoring. As you recover from surgery, you may be discharged home or transferred to another room. Note: If you use CPAP please bring all your equipment to the hospital with you. Will my family/friends be allowed to visit? Yes, your family and friends can visit. You are restricted to a maximum of two visitors at a time. Limit your visiting time to short visits as you need to rest and recover from your surgery. Visiting Hours 11:30 a.m. to 2:00 p.m. 4:00 p.m. to 8:00 p.m. Please discuss any special visiting needs with your nurse. Will I have access to a television or telephone? Telephone and television are available for a fee; however incoming calls may be restricted to provide adequate rest required for recovery. May my family call the Observation Sleep Apnea Room? Yes. Your family may telephone the unit to inquire about your condition. However, in order to limit telephone calls, it is required that only one family member calls on behalf of the whole family. 13 Patient safety is very important to the Queensway Carleton Hospital and this information is provided to patients and their families to help inform you of your essential role in your own safety. The information contained in this booklet is not specific medical advice, nor a substitute for medical advice. For your safety, it is advised that you speak with your doctor and healthcare team about your particular health care needs. Protect yourself! Clean your hands frequently, ask your health care providers and visitors to do the same. Clean hands save lives! 14