[jwk]

Originally Posted by MamaCheese

This is the way I like to do it. Our facility does allow one parent to accompany the child into the OR. It's usually more traumatic for the parent than it is for the child.

Which is the exact reason they shouldn't be there.

[Hopefull2009]

Originally Posted by jwk

Which is the exact reason they shouldn't be there.

But why not?

To me, that is the job of a parent...they need to suck it up and be there for the chlid.

I think it is 100% unnecessary to put a child through any unnecessary trauma IF it can be reasonably avoided.

In emergency situations, obviously it can't be. That is just life.

However, I would hate to think that a chlid's comfort and fears are being completely dismissed just because they are too young to comprehend what is going on, understand what is going on, and too much of a focus on "git'er done".

[jwk]

Originally Posted by Hopefull2009

But why not?

To me, that is the job of a parent...they need to suck it up and be there for the chlid.

I think it is 100% unnecessary to put a child through any unnecessary trauma IF it can be reasonably avoided.

In emergency situations, obviously it can't be. That is just life.

However, I would hate to think that a chlid's comfort and fears are being completely dismissed just because they are too young to comprehend what is going on, understand what is going on, and too much of a focus on "git'er done".

You need to read my earlier post or read it again if you read it before.

You're thinking that it's better for the child having the parents there. It's not. Parents are understandably stressed about surgery and anesthesia, and kids will pick up on that, even if the parents put on a happy face. It has nothing to do with dismissing the fears of the child, , nothing to do with moving things along, and nothing to do with the parents "sucking it up". I can't tell you how many parents break down, even on minor cases like ear tubes.

It's all about what is best for the child, and having the parents there is rarely, if ever, what's best FOR THE CHILD. I don't care how many parents think their child just won't be able to handle it - that's the parents fear, not the child's.

[JustaPatient]

This is MY EXPERIENCE AS A PATIENT and what my mom has told me about my past experience that I do not remember

I had my first surgery at the age of 2 at one hospital. Aparently I saw a child life specialist a while before. She talked me through what was going to happen and gave me a mask to "practice" with (aka get used to so I did not freak out). My mom says that did wonders because I did wonderful and was excited to show how I knew how to use the mask.

At the hospital I am now a patient they allow 1 parent (or the best person to support the child) into the OR with the child. Also with younger patients the parent is brought into the Post-Op (as it is explained by child life the "wake up room") BEFORE the child is awake.

It is called the PPI (parent present induction program). They screen for appropriatness at the pre-op visit a few days prior to surgery. If a child is found to be a good candidate for the program the staff gets the parent ready to know what to expect. My hospital has been doing it since 1989.

If a child needs to be restrained I do not know how they do it. I have never (to my recollection) needed to be.

[ewattsjt]

As a patient it is easy to see only one side of the issue just as it is for a parent who works in the OR. I have been in and out of hospitals most my life (not for a chronic disease but for injuries as a result of what I believe to be ADHD). I too have never had bad experiences with surgery and am quite relaxed about it. Within the same token; working in the OR has shown me that everyone is not the same. I have seen people be as relaxed as me and I have seen some totally freaking out, even have had some to cancel the case once they got to the OR. That is where patient assessment comes in, including the assessment of the family with the child. Even children have a varied type of personalities that can be benefited by a parent being there or some who would be best suited if the parents never left the pre-op area.

I personally do not believe that it is best either way, because policy or routine does not determine the child’s state of mental preparedness. I feel it should be done on a case by case basis. Yes, it would take more time but would truly be in the best interest of the child.

Just my personal opinion.

[mcmike55]

The PO Versed is really nice, unless you get a doc that's too pushy and won't give it time to work!!
Frankly, my favorite, is I guess what you are calling a smother technique, I would rather consider it a swaddle/bear hug technique.
I'll let them hold their bear, blanket or what-ever, right up against them (it keeps their hands busy, at least for a while) then I cover 'em with a big warm cotton blanket.
Then I just lean over them, talking to them all the time, (me or the anes. doc).
This, depending on the size of the child, effectively controls the entire body, except the head, which the anes. doc has control of.
Some of our docs have used Sevo. Saw a one breath induction once.
Very impressive.

Mike

[DNRme]

No parents in the OR... in >20 years of experience is the best policy. Did trial it once and the nurse in the room wound up with 2 patients, with the mom feeling lightheaded. I work nights now, and there is no one else around to bring the parents to the waiting room, even if it were the best situation.

I have found that a few soft words, distraction, and holding the child in a warm blanket goes miles in preventing the need for restraints. After a few breaths of inhalant, lay the child on the bed and do what needs to be done.

[JustaPatient]

Originally Posted by DNRme

No parents in the OR... in >20 years of experience is the best policy. Did trial it once and the nurse in the room wound up with 2 patients, with the mom feeling lightheaded. I work nights now, and there is no one else around to bring the parents to the waiting room, even if it were the best situation.

I have found that a few soft words, distraction, and holding the child in a warm blanket goes miles in preventing the need for restraints. After a few breaths of inhalant, lay the child on the bed and do what needs to be done.

After all the surgeries I have had it does not scare me anymore to go under anesthesia. There is of course always that little bit of an edge. The soft words and nurse holding my hand gets rid of those last few nerves. It makes me feel like there is AT LEAST one person in the OR who cares about what happens to me.

I know the doctor does, and that all the personnel in there should, and probably do. For the older children (in which I include myself even though I am now 20) I feel like it is a feeling that we can not control what is going to happen to our body. We are totally at the mercy of the people who are in the OR caring for us.

[Marvie]

There are very good reasons why parents are not allowedin the OR during induction. Have you ever had to deal with a parent who got so upset during intubation that they picked up their already anesthetized child and ran out of the OR? Well, I have and it was not a fun time... NO parents in the OR. If you tell a child stories and let them share in the hooking up of the BP cuff and monitors, they are so much more willing to be induced. Children are always going to be scared when away from their parents, however, if you distract them, tell them silly stories, ask them questions...etc...they do calm down and not throw hissy fits.

Originally Posted by Hopefull2009

No...the REASON they are kicking and screaming is because they are taken away from mommy and daddy and have a ton of people taking them into a strange place, surrounded by tons of activity, and they are trying to hold them down.

That scares a child to death!

If a parent is there, soothing them, holding them until the mask is in place, assuring them the mask isn't going to hurt them and to just breathe....to me, that sounds like alot less traumatic than anything you are describing.

Then once the child is asleep, the parent leaves and waits to be called to recovery, where the parent is again present so the child can see them first thing.

Also, when possible, arrange for a child to be taken into the OR so they can just see the room....alot less scary if they have seen it before.

Someone there needs to get more creative with the process.

[Hopefull2009]

Originally Posted by Marvie

There are very good reasons why parents are not allowedin the OR during induction. Have you ever had to deal with a parent who got so upset during intubation that they picked up their already anesthetized child and ran out of the OR? Well, I have and it was not a fun time... NO parents in the OR. If you tell a child stories and let them share in the hooking up of the BP cuff and monitors, they are so much more willing to be induced. Children are always going to be scared when away from their parents, however, if you distract them, tell them silly stories, ask them questions...etc...they do calm down and not throw hissy fits.

Can't say that I have...and hope that I never do.

I wasn't suggesting that the parents stay for the entire induction or the surgery.

I did have the opportunity this summer (I'm a student) to observe 3 pediatric surgeries...1 infant and 2 preschoolers.

The hospital did let the parent come back, only one....but only until the child was groggy and unaware of their surroundings...and they were quickly removed right before the intubation...so the parent didn't have to see that.

Then the parent was brought back to recovery so he/she could see the parent when they woke up.

I've got a tough stomach, but watching an intubation on a child was hard, and I know that if I saw 1000 of them I couldn't watch it on my own children.