The day of the operation

Theatre Direct Admissions (TDA)

TDA is a room on Robin's Ward in Oxford Children's Hospital, where children come to get ready for their operation and also have their 'work up' to prepare them for their operation.

Time of arrival

Please arrive by 7.30am and wait in the area just outside Robin's ward. A member of staff will call for you.

As we will have explained, your child will have been fasting before their surgery. Before you come to theatre, we will also check that your child hasn't developed a cough or cold overnight.

We will show you to a seat in the Theatre Direct Admissions (TDA) waiting area, where the nursing team will get your child ready for theatre. You will also meet members of the Craniofacial Team.

Don't worry if you still have questions: you will see the surgeon and anaesthetist in the morning, before coming to theatre, so you can ask then.

Preparing for surgery

We will apply a numbing cream we call 'magic' cream to your child's hands and/or feet; this can make the insertion of a cannula more comfortable for your child.

The nursing team will go through a checklist of questions, check your child's oxygen levels and heart rate using a simple probe attached to their finger, and check their temperature with a thermometer.

While they do this, we are also checking that the theatre team is ready, equipment available, blood tests completed and that a bed is available for your child in the Paediatric High Dependency Unit (PHDU).

We may have to wait for a bed on PHDU, or there may not be one available. If there is no bed available on PHDU, your child's operation unfortunately cannot go ahead, and we will rearrange it for the soonest possible date.

We will only call for you to bring your child to the anaesthetic room once everything is ready. Sometimes there is a delay, but we will let you know if this is the case, and review the fasting instructions if we can.

The team in TDA will receive a phone call to say that the doctors are ready for you in theatre. This is when we will help you to change your child into a gown.

Anaesthetic room

The play specialist or nurse will walk with you down to the anaesthetic room. We normally allow only one parent or carer in the anaesthetic room for safety reasons, (we will discuss and agree this with you in advance).

In the anaesthetic room, we will ask some questions as part of the pre-operative check. We will then begin the anaesthetic as agreed, either by putting in the cannula or using the mask.

Once your child is asleep, we will ask you to leave, and return to the ward with the person who brought you to the anaesthetic room.

Waiting

The operation usually takes three to four hours, but your child will be away from you for most of the day. This is because, once your child is asleep, time is spent preparing them for their surgery.

We are unable to give you continual updates throughout the day, as the team needs to focus on the operation. Some parents find this difficult, so we recommend trying to stay busy - there are many interesting things to do in Oxford.

After surgery

Once the surgery is complete, the surgeon or a member of their team will call you with an update. When your child is stable, the anaesthetist will transfer them to the recovery room next to the theatre. This is where your child will recover from the anesthetic. We will monitor them very closely, making sure that they are comfortable, stable and awake.

After about 30 minutes to one hour we will transfer your child to the Paediatric High Dependency Unit, and, following a brief settling in period and handover, reunite you with your child at their bedside.

Under normal circumstances we would expect your child to spend the night on the Paediatric High Dependency Unit, and then we will transfer them to Robin's Ward the following day.

Link

Children's Inpatient Management of Pain Service (ChIMPS)