After an anxious wait, the baby’s mother and family may start thinking specifically about the baby’s surgery after receiving the call for admission. From the doctor’s point of view, it is important to remind the baby mothers of the following things that they should pay attention to.
I Pre-surgery preparation.
1.Most babies come from suburbs (counties), foreign cities, provinces and even foreign countries. Baby mothers need to be concerned about the weather changes in Chongqing 3-5 days before admission and about 1 week after admission, and also consider the temperature difference between the two places and the strenuous journey to strengthen the care and try to avoid the baby catching a cold, if they catch a cold they cannot have surgery.
2, hand surgery baby intimate underwear wear slightly looser chest with buttons (preferably with 2 pieces in order to change), do not wear the kind of overhead. Because the surgery, after the surgery will have monitoring equipment electrode piece post in the baby, the main thing is that after the surgery baby good to dress and undress. After the surgery, the baby dresses with sleeves first on the operated side, then on the non-operated side; the opposite is true when undressing, that is, first on the non-operated side, then on the operated side. It is best to wear slightly looser autumn pants for foot surgery, not the kind of pants with elastic opening, because the post-operative bandage will increase the volume of the foot, making it difficult to put on and take off the pants, and forcibly putting on and taking off will affect the effect of surgery.
3, before admission, it is best to cut off the baby’s long finger (toe) nail, too long finger (toe) nail easy to hide bacteria, resulting in surgery site infection.
4, 1 week before admission, it is best to take extra care of the baby to avoid trauma to the hands and feet, mosquito bites, etc. Try to change the baby’s habit of biting fingers, bite fingers before surgery may cause skin damage, bite fingers after surgery is easy to wet the dressing, affecting wound healing.
5, 2 weeks before and after surgery, it is best not to take vaccination, it is best to consult the vaccination doctor beforehand. Because some vaccinations may cause fever, which may interfere with the preoperative and postoperative evaluation.
6.If some babies have other systemic diseases, such as asthma, congenital heart disease, etc., it is best to consult a specialist for evaluation before admission to see if anesthesia and surgery can be performed.
7.If the baby’s parents cannot be present when the baby is hospitalized for some reason, ask the baby’s mother or father to write a power of attorney to temporarily entrust the custody of the baby in the hospital to someone who will take care of the baby (because the hospital stipulates that only the baby’s legal guardian has the right to sign the consent form for surgery and anesthesia).
The main points of the power of attorney are: XXX (name of father or mother), male/female, is the father or mother of XXX (baby’s name), ID number, cannot be present during the hospitalization of XXX (baby’s name) for some reason, and entrusts his custody during the hospitalization of XXX (baby’s name) to XXX (name, gender, relationship to the baby, ID number of the person entrusted), and entrusts him to sign the surgery Consent form, anesthesia consent and other matters. Finally, the handprints of the principal and the entrusted person should be stamped.
8. It is better to bring thin stockings before the surgery, so that they can be placed outside the dressing for protection after the surgery.
II Preparation after admission.
1.On the day of admission, the doctor will look for the baby’s parents to understand the condition, write the medical record, open the pre-operative checklist, and the bedside nurse will conduct health and nursing education. Parents should not all leave, it is better to have one person in (or delegated person in). Do not take the baby too far from the ward, as the doctor or nurse may be looking for the baby at any time for examination or care, etc. Each bed will be managed by a regular doctor or nurse who will be introduced to the parents upon admission, and you can go directly to your own bedside doctor or nurse if something needs to be dealt with. If there are more family members taking turns to take care of the baby, you need to explain what the doctor or nurse told you during the handover to avoid omission of matters affecting the follow-up.
2. Make an appointment as soon as possible when you get the checklist, because there are more children in the hospital and some tests require a longer queue. Early delivery of urine and stool for examination. Parents can pick up the baby’s urine according to the baby’s usual urine habits, and it is best to pick up the urine easily when the baby is expected to urinate. It is best to wash the foreskin or vulva before receiving urine, and to receive the middle part of the urine (because urine can easily be contaminated and affect the test results). Don’t unwind the urine into a basin or other container and then pour it into the urine cup, as it will easily contaminate the urine and affect the test results. The stool can be taken from the diaper. For babies with hand and foot deformities, it is best to complete the X-ray examination of hands and feet on the day of admission (see point 4 for reasons).
3. Babies may cry during the examination, which may affect the examination results, so some examinations require sedation. When you make an appointment, you will get an appointment number. Half an hour in advance, you can find a bedside doctor to prescribe sedative medication, and then find a nurse to give the baby medication (children’s hospitals most commonly use chloral hydrate to sedate, either orally or by enema, because of the poor taste of sedative medication and the possibility of vomiting causing accidental aspiration, so now generally use enema is safer). Find a quiet place to put your baby to sleep after medication. Not every baby can fall asleep after medication, in order to enhance the effect of sedation, sleep deprivation can be used, that is, in the hours before the baby check-up not to let the baby sleep, afternoon check-ups do not nap, try to tease the baby to play, so that it is sleepy, can be asleep during the examination.
4.After the doctor’s shift in the morning of the second day of admission, parents will be asked to bring their babies to the doctor’s office (usually around 8:10, so parents had better not go to breakfast at this time). Professors will check again, look at X-rays, examine and revise the written medical records, draw up and inform parents of the surgical plan, arrange the surgery and other matters.
5.According to the surgical plan set in the morning, we will make preoperative preparations, and then find the parents to talk about the detailed surgical situation and sign the surgical consent form, and the parents should not leave the ward all that day.
6.As some test results come back late, the doctor on duty will check the test results that night after all the results come back, and if there is any abnormality, it will need to be reviewed. If no doctor informs us of abnormal results, all of them will be normal.
7, preoperative fasting, fasting 6-8 hours, there will be a nurse to inform the fasting time in advance, do not be afraid of the baby hungry secretly feeding, this is harmful to the baby, because fasting time is not enough, after anesthesia may occur stomach contents reflux, causing choking or choking.
Preparation for the day of surgery and beyond.
1. There will be several surgeries every day, and there will be emergencies at any time. There is always a sequence of surgeries, and the general principle is to do the younger babies first, and then the older ones. In addition, professors usually have administrative duties, such as meetings, teaching, etc., and sometimes need to adjust the order of surgery according to the specific circumstances of the day. The baby will cry when hungry and the parents may be anxious, please do not rush the doctors and nurses because there is nothing they can do.
2.After the baby is admitted to the operating room, the parents can return to the ward and wait. If it is at lunch time and it is estimated that time allows, it is better to have lunch because the baby may not have time or mind to eat after coming back.
3.The anesthesiologist will ask if you need an analgesic pump when you sign the anesthesia consent form before surgery. However, some parents choose not to use these drugs because they are worried about the effect of these drugs on their children. There are advantages and disadvantages, please consult anesthesiologist.
4.After the surgery, the baby will be sent to the ward. At this time, the nurse and the resuscitation staff in the operating room will tell the parents to pay attention to the child’s face, lip color and other matters that need attention. Some of the babies will cry a lot after coming back, parents can hold the baby’s elbow or wrist joint without too much force to keep the baby’s hands and feet from touching or tearing off the lines of the infusion tube or monitoring instruments. Generally 4-6 hours after surgery can start to drink, first try to feed the baby a small amount of water, did not occur vomiting, can then feed a small amount of water and milk several times, do not feed too much at once. Try not to eat too much on that day, the next day you can basically eat normally. In general, babies with hand and foot surgery do not need special supplements (such as pigeon soup, etc., too greasy may cause diarrhea), normal diet can be. Some babies may have fever after surgery, generally below 38.5 ℃ without special treatment, symptomatic treatment can be.
5.After completing the surgery on the same day, I will personally inform the family of the professor who performed the surgery, the general procedure, the special features of your baby’s surgery and the special precautions needed after the surgery.
6.After the operation, we will try to elevate the affected limb, no matter sitting, holding or tripping, above the heart level, so as to reduce the swelling of the hands and feet after the operation, which is also conducive to the decreasing of the swelling.
7.Our surgery will generally be bandaged for 2-3 weeks after surgery, during which the medication will not be changed. During this period, parents need to do their best to look after, the professor often said that seven points of surgery three points of care, not the end of the surgery is over, the post-operative care is very important, directly affecting the results of surgery. Post-operative care is very important and has a direct impact on the outcome of the surgery. Hand and foot surgery should not be subjected to violence, as this may cause bone displacement and affect the outcome of the surgery. The dressing should not be wet, because the dressing is not as good as the dressing at the time of surgery, and our surgery is generally not in a cast, and some of the dressings are fixed and shaped. The implant should never be wet because changing the dressing after wetting will cause necrosis of the skin piece. After surgery, you can wear stockings to protect the dressing dry and clean.
8, generally 4-5 days after surgery can be discharged, I will personally explain the precautions and review time when discharged (if the rest of the day is not in, you can contact through the Internet). If the field can not come back to change the baby, when discharged from the hospital can be issued a medical condition, to facilitate the local doctors to deal with before understanding the surgery. You can also contact the professor of surgery or me online or by phone. You need to bring medical records and X-rays for outpatient review. Insist on coming to the outpatient review of the main professor 1-3 months after surgery. 1-3 months after surgery is the shaping period, the main professor understands the surgical process and some problems can be found and dealt with in time, so as to achieve the best recovery effect.
9.We will do our best to complete each operation, and it is the greatest wish of parents and doctors that their babies can have the best recovery effect.