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When your child comes into the hospital for surgery, we want to ensure that you have all of the information and support that you need. 

We hope you will find most of the things you need to know in the information below but if you have any other questions, please contact your cardiac nurse specialist.

If you already know which section you want to look at, you can use the bookmarks below:

Admission to the ward

The day of the operation

What to expect after theatre

Transfer to the ward


Admission to the ward

What will happen when we arrive?

We hope that we will already have seen you in pre-admission clinic before the day of your child's admission. We will also need to see you and your child before the operation.  This allows us to check that your child is well enough to undergo surgery.  You will also be asked to sign the formal operation consent form at this time.  This documents;

  • that you have had the opportunity to discuss the operation with a surgeon,
  • that you understand why we believe it should be done,
  • what exactly is going to be done,
  • that there are risks with doing the operation (we will give details of what these are)
  • that you want us to proceed with the operation.


Ward 32 _ALV6535.medium.jpg

This is an extremely important consultation. If you have any questions that remain or you have thought of since the time we met you in outpatients, this is the time to discuss them so that we can make sure that you are as ready as possible to proceed to surgery. Whilst every effort will be made to ensure that the surgeon you meet will be the surgeon performing the operation, this is not always possible. However, the surgeon carrying out your child's operation will always be experienced enough to do it well.


Will there be more tests?

The anaesthetist, who will be looking after your child during the operation, will also come to meet you and your child during this time.  This is an opportunity for you to ask questions and to discuss the anaesthetic options available to your child and about intensive care.  

The nurse who admits you to the ward will go through your family information and take your child's temperature, heart rate, blood pressures and saturations.  They will tell you when your child needs to stop eating and drinking.  If you have not attended the pre-admission clinic, the nurse will also take your child's height and weight and arrange for a blood test, Echo and Electrocardiogram.

Can we visit the Intensive care Unit?

PICU in action

Your nurse will usually be able to arrange a visit to the Paediatric Intensive Care Unit (PICU).  This is a very big and busy room where your child will stay for observation following their surgery.  Visiting PICU before your child is admitted will help you familiarise yourselves with the environment.  We will try our very best to offer this to you, but it may not be possible if the unit is closed to visitors which is sometimes necessary.

What if my child's procedure is cancelled on the day?

Unfortunately it may be necessary to cancel an operation from time to time on the day it is planned. This usually happens for the following reasons:

  • An emergency patient has been admitted and needs to take priority
  • Previous operations may take longer than expected due to unforeseen circumstances
  • There may not be enough staff to do the operation safely either in PICU or in theatre
  • There may not be a PICU bed available
  • Your child may have become unwell overnight

If we know in advance that a cancellation is likely to happen, we will try to contact you before you leave home.  If you are already at the hospital, we will do everything we can to rearrange the surgery within a short time to avoid a wasted journey.  However, this may not always be possible.  If your child's operation is cancelled we will talk to you about the reasons.


The day of the operation

How do I help my child get ready for surgery?

On the day of your child's operation, please ensure that your child has been bathed or showered and young people have removed any jewellery or nail polish. Your child will need to stop food or milk 6 hours prior to surgery and clear fluids from 2 hours.  Your ward nurse and the anaesthetist will give you specific times for your child.  They may also be given a "pre-med" to help them be calmer before surgery.  

Can I go with my child to theatre?

When theatre calls your child will be taken down to theatre by a nurse.  It is usually possible for at least one parent to accompany your child down to the anaesthetic room and this is something that you can discuss the day before with the anaesthetist. Your child may need a hospital trolley if a pre-med has been given. A porter will push your child on the trolley.  You can usually stay with your child until they are asleep

How long will surgery take?

SurgeryBefore the operation we will give you an estimated time of how long the procedure will take, but sometimes parts of the operation can take longer that we expect.  This does not necessarily mean that anything has gone wrong.  As well as the actual time to do the procedure, there is also anaesthetic time while your child goes to sleep and is prepared for surgery with the necessary catheters etc that the anaesthetist will have explained. Once your child has arrived in PICU time is needed while the machines are set up and your child is settled there.  

However, we do understand that this can be a very stressful time and if you are worried that all this is taking longer than anticipated, you can speak to the cardiac nurse specialist or cardiac surgery coordinator.  

Where should I go during surgery?

Your child's nurse will then take you back up to Ward 32 to pack up your child's belongings.  Following your child's operation they will be a patient on Paediatric Intensive Care Unit (PICU) and so will no longer have a reserved bed on Ward 32.  There is a storage area for your child's suitcase on Ward 32 whilst they are in PICU, so ask your nurse to show you where this is if required. You may choose to stay in the hospital during the operation but families have told us that it can be helpful to go out.  Whichever you choose, we will make sure we have a means of contacting you so that we can let you know as soon as your child comes out of surgery. You can then go to the PICU parents' room and we will come to see you as soon as we are free.

Will you be able to update me during the operation?

We will not be able to do this while your child is in surgery.  This is because everyone in the operating team is focussing on your child's operation and it is important that they aren't interrupted. However, if there are any events that we need to talk to you about whilst your child is in theatre, we will contact you.

What to expect after theatre

Where will my child go after surgery?

Your child will be taken to PICU directly from theatre once the operation is complete.   Here, your child will be looked after by a specialist intensive care nurse.  PICU will contact you once your child had been settled into the unit post operatively.  Your child will be monitored by a nurse at the end of their bed, and doctors also regularly review your child.  The nurse will try to answer any questions you may have, and will refer to a doctor any questions he/she is unable to answer.  The nurse looking after your child will give you a 'Welcome to PICU' leaflet giving you lots of useful information about what to expect whilst your child is in PICU.  Its important to realise that your child will look rather different after surgery and will look rather pale. There will be breathing tubes attached by tapes to some of the face, there will be dressings and catheters in various places such as the side of the neck, hands and wrists and in the groin area.

What equipment will my child need after surgery?

After surgery your child may have some of the following equipment and items attached to them:

VentilatorPICU monitors

Your child may have a tube down their nose or mouth to support their breathing (ventilation) after surgery.   For this, they will need sedation with medication.  During their recovery the ventilator will gradually be reduced until they are able to breathe on their own without the machine.  They will then be 'extubated' (the tube removed).  We may give them additional oxygen after this either using a face mask or prongs inserted into the nostrils.  In infants we may use head box oxygen which allows us to give warmed, humidified oxygen to the child that will allow them to cough and keep their lungs clear more efficiently.

Nasogastric tube

This is a fine tube that is passed through the nostril into the stomach.  This allows us to give food and medication.

Intravenous access & 'Arterial line'

Your child will usually have a small plastic catheter placed in their neck, often referred to as a "Central Line".  This is a very important item as it allows us to measure the pressure within the heart and also to give medications securely into the circulation.  These include drugs that will help control the blood pressure as well as medication. Another small plastic catheter will be placed into a vein somewhere else, usually a hand or foot, that will allow us to give fluids and other medications as required.

There will be a small plastic catheter inserted into an artery, most often at the wrist or at the top of the leg. Often referred to as an "Arterial Line". This is used to monitor the blood pressure and is also used to take out blood samples to check on the functioning of the lungs and informs us how best to set up the Ventilator (see below).


Your child will be connected by wires to a number of other monitors that give us continuous information on a number of other vital signs. These include oxygen saturation, heart rate and rhythm, respiratory rate, temperature and blood pressure.  These are all shown on a large monitor that is above your child's bed.

Pacing wires

Most children will have little wires coming through their skin.  Normally these wires are wound up and attached to the child's chest but sometimes they may be attached to a pacing box.  They can be used to control the heart's rhythm and are sometimes necessary after a heart operation if the conduction system in the heart has been affected by the operation.  If the pacing wires are being used, this is usually temporary.  A day or so after the operation, if they are not being used, they can be removed often under sedation, particularly for smaller children, by gently pulling them out.  This is not painful, but creates a tickling sensation as they come out.

Chest drains

After cardiac surgery each child will have one or two chest drains coming out of their chest.  These are necessary to remove any fluids that build up after the operation.  The drains will remain in place until the fluid has stopped being produced.  This may be a number of days after the operation.  When it is time for them to be removed, they are pulled out after the child has been given some sedation.  A black stitch is used to close over the small incision that is left behind and this stitch will be removed 5 days after the drains have been removed, either in the hospital or by your district nurse.

Urinary catheter

Each child has a catheter placed to drain the bladder after a heart operation.  The amount of urine that is produced is a very sensitive and useful indicator of how the heart is functioning after the operation and how your child is recovering.  It is therefore very important to know accurately how much urine is being produced.

Transfer to the ward

When will my child transfer to the ward?

Once the clinical team are happy that your child is stable after the operation and no longer needs to be on the intensive care unit, they will be transferred to the ward.  This may be on the day after the operation or a number of days later: it depends on your child's progress.  Initially they will go to the High Dependency Unit (HDU).  This is a very good sign that your child is on the road to recovery and is ready to move from one to one care, to the specialist care of the HDU nurses, who each look after two patients.  This care will usually be provided on Ward 32 in the specialist HDU, but may also be provided on PICU on some occasions.  We realise this will be a time of adjustment so please talk to the cardiac nurse specialist and the nurses caring for your child if you have any questions or worries.

What's the difference between the High Dependency Unit and the rest of Ward 32?

Whilst on HDU, your child will be reviewed on the doctors rounds twice a day, which start at 9am and 4.30pm.  On the ward round you will see doctors from Ward 32, doctors from PICU and nurses from HDU.  You can speak to the team as part of the ward round but if at any time you are worried about your child, speak to the nursing staff. They will talk to you about your questions or concerns and agree a plan of action with you.   There is also a poster by the side of your child's bed which will remind you how to raise any concerns so that we can take the very best care of you and your child.

After a time, your child will be well enough to move onto the main part of Ward 32.  Here, the nurses are all experienced in looking after patients following heart surgery or with heart conditions and each nurse will look after three patients.  This is a further sign that your child is recovering well.  During this period we will start talking to you about discharge.  You will find out more about looking after your child following cardiac surgery, and particularly what medications they need and what they do.  Again, your child will be reviewed by one of the consultant cardiologists on the ward round every day, usually in the early part of the morning.  This is an opportunity for you to meet the doctors and ask any questions that you may have as we want you to be as much a part of the care of your child as possible.  Also we do not want you to worry about things when we can help reassure you.  However, being able to contact your doctor is not solely limited to these times and if you ask your nurse, a time can be arranged for you to meet with anyone in the team.

For more information on Ward 32, click here

Who else is there to support us?

cardiac nurse specialists

There is a wide team available to support you and your child during your stay; you can talk to the cardiac nurse specialist and or the clinical psychologist all of whom are regularly available on the ward. The play specialist will be able to help your child understand and cope with their time on the ward as well as providing activities and entertainment.

You can find out more about these services from your child's nurse.

If you need more practical support, you can ask for a referral to our 'Martha Care' Family Support worker or contact her direct via the LIAISE team.

Getting ready to go home?  Click here for more information