I work for a large hospital with a children's hospital attached, so my situation may be a little easier, but hopefully can be helpful. Because our dept treats kids from the Peds hospital, we have pre-op Peds decorated rooms as well as ORs. We also have a Child Life Specialist in pre-op and ED, that talk to them and play games and stuff to distract the kid. If they have to be on a gurney, they get an iPad to play a game, even as they are going off the sleep. Toddlers that can, are pulled in a wagon with the CLS blowing bubbles at them; kids a little older get to drive those power wheels jeeps into the OR. We also have fellowship trained Peds Anesthesiologists. Except for babies obviously, they are the ones to explain what's going to happen. Kids under 13 don't get IVs unless they are already IP until they're asleep so that's one less trauma, so they go to sleep with gas. We have scented masks, so they let kid pick out what scent, show them how it will go over the face while mom/dad are there, then let them keep the mask til they come back to the OR. As the OR nurse, I always explain to the parents the process. If the kid is old enough, I try to tell them again what's going to happen. Until they are a little older, taking them away from the parents is hard on them no matter what you say or do. Some parents will walk to the main OR doors with us, others will stay back and you just have to go, even if you're carrying them kicking and screaming all the way. They are awake in the OR such a short period of time I don't think there's really anything for them to see that you need to warn the parents about, that may just make the parents more nervous. And only on very rare occasions do we allow parents to come back with us, I think that makes it more difficult on the kid.