Planning for Your Surgery
PeriAnesthesia refers to the care given to patients immediately before and immediately after surgery. Through the pre-surgical planning (PSP), pre-operative, and post anesthesia care process, an emphasis is placed on educating patients and their families/caregivers on their particular surgical procedures and providing support during this stressful time.
Pre-Surgical Planning (PSP)
Once surgery has been scheduled, your physician will refer you to the PSP office. The RNs in PSP complete a history and assessment. This may be performed by phone or in person (the PSP office is on the first floor of the hospital near the rear of the main elevators). If your physician orders any pre-admission lab work, an EKG or x-rays, you may be required to come in prior to your day of surgery to complete these with the PSP staff.
The Day of Your PSP Appointment
Upon arriving at the hospital, please go to Admissions (located on the 1st floor just past the lobby) to register and complete paperwork. In PSP, the RN will conduct a health history assessment to insure diagnostic needs are met, lab work is complete and an anesthesiologist has been consulted, if necessary. To guarantee the PSP RN obtains all the correct information about your health history, please be sure to bring the following information:
- A complete list of all current medications, doses and frequency (including prescription, over-the-counter and vitamins/herbal supplements).
- A complete list of past surgeries and/or major illnesses.
- A medical insurance card.
- Copies of your Living Will and/or Advanced Directive/CPR Directive.
The Night Before Your Surgery
(**always follow the instructions by your surgeon if different from below**)
- Stop eating solid food by midnight (unless otherwise directed by your surgeon).
- Refrain from eating gum, mints or hard candy after midnight.
- A maximum of 16 ounces of water or clear liquids may be consumed up to two hours before the arrival time at the hospital day of surgery (unless otherwise directed by your surgeon).
- Certain medications may be taken with a sip of water the morning of your surgery (the PSP RN will discuss these medications with you).
- If you smoke, it is highly recommended that you quit 4-6 weeks prior to any elective surgery. All smokers are highly encouraged to refrain from smoking 24 hours prior to surgery.
- Avoid alcohol or limit alcohol the night before surgery.
- Please do not shave your surgical site. Report any cuts or abrasions on your skin to your pre-op nurse or physician prior to surgery.
- Please notify your physician of any recent colds or flu symptoms immediately, preferably prior to coming to the hospital on the day of surgery as your surgery may need to be canceled.
The Morning of Surgery
- Shower the morning of your surgery before coming to the hospital.
- Do not wear any makeup, jewelry or perfume. Eye make-up may cause very painful corneal (eye) abrasions during surgery. If any nail polish is worn, it must be clear or very lightly colored.
- If you wear contact lenses, dentures, or hearing aids, please remember to bring the cases and solutions for storage during surgery.
- If you are scheduled for lower extremity orthopaedic surgery and have or will need crutches, please bring them to Pre-Op.
- Please leave all valuables (cash, credit cards, jewelry, electronics, etc.) at home or check them in at Admissions with Security for placement in the hospital safe. Leave purses and bulky personal belongings in the car or with family members as we do not have secure storage for these belongings in Pre-Op/PACU.
- Dress in loose, comfortable clothing.
- Please bring your insurance card and ID with you along with a form of payment if a co-pay is required.
- If you are planning to go home the day of surgery, we do request that you/your significant other bring some form of payment (cash, credit card, etc.) to purchase discharge prescriptions at the outpatient pharmacy.
Pre-Op: Arriving at the Hospital for Your Surgery
- Report to Admissions, located off the main hospital lobby, to register. Admissions staff will have you verify personal identification information and place a hospital name bracelet on your wrist. This bracelet must be worn until discharge from the hospital.
- After completing the Admission process, you will be directed to the Pre-Op Department on the 3rd floor, where the Pre-Op RNs will get you ready for surgery. Visitors are limited to one per patient. All other visitors can wait in the Waiting Room, located on 2R.
- The nurse will review all your medical information entered by PSP (this includes medical/surgical history, all medications, allergies, planned surgery, site of surgery, etc.). This process may seem repetitive, but it is a safety check and must be done by all medical/nursing staff caring for you on the day of surgery.
- Immediately before surgery, you will meet with the anesthesiologist to discuss your anesthesia care.
- We highly encourage you to ask any questions throughout the perioperative stay if anything is not clearly communicated to you.
- If you are having outpatient surgery (going home the same day as surgery), you MUST have a responsible adult available to drive you home by the time discharge is anticipated.
- Inpatients are asked to have their driver arrive at the hospital no later than 11 AM the day of discharge.
Prescriptions and Non-Prescription Medications
- Your regular medications will be ordered by your physician during your stay at the hospital. It is very important that your surgeon, anesthesiologist and nurses know the exact name/spelling, dose and frequency of all your current medications (includes all prescription, over-the-counter and vitamins/herbal supplements).
- Your surgeon and/or pre-admission nurse will give you instructions on which medications to take and which medications to avoid prior to the day of a scheduled procedure.
Post Anesthesia Care (PACU)
The Post Anesthesia Care Unit (PACU) is also called the recovery room. After surgery, you will be transferred to the PACU for close monitoring. The PACU staff is composed of RNs, who are Advanced Cardiac Life Support (ACLS) and Pediatric Advanced Life Support (PALS) certified. PACU RNs assist patients to a safe return to consciousness post anesthesia, minimizing complications or adverse reactions to drugs and treatments.
The PACU Patient Experience
Upon arriving to the PACU, you will be connected to continuous monitoring systems that a PACU nurse will check frequently (includes blood pressure, respiration and heart rate and rhythm). The nurse will also assess and monitor dressings (bandages), regulate intravenous (IV) fluids and administer pain medication as necessary. Patients vary in the time it takes to fully awake from anesthesia. The average length of stay in the PACU is 1-3 hours depending on inpatient vs. outpatient status. If you have to stay longer than expected, do not be alarmed! A longer stay may be necessary to insure you receive the very best care and are as comfortable as possible before being discharged home or transferred to the inpatient unit.
The surgeon will typically call your designated family member or significant other (contact person) after the surgery via cell phone. After you are stable and all initial assessments are documented, the PACU nurse will call and update your contact person. Visitation in PACU is based on the patient's condition and ongoing activity in the department. We do make every effort to allow brief visitation (5-15 minutes) and will encourage one significant other/family member/friend to participate in the discharge teaching just prior to going home.
Patients Staying Overnight or Longer
If you are scheduled to stay a night or more in the hospital, you will be transferred from PACU to the in-patient unit (PCU-Patient Care Unit). It is highly advisable to leave all your overnight supplies in the car or with a family member due to lack of secure storage for personal belongings in Pre-Op/PACU.
Goals for Discharge From PACU
You must achieve certain criteria before discharge from PACU, whether you are staying the night in the hospital or going home. If you are scheduled to go home after surgery, you must:
- Be awake and alert enough to verbalize understanding of discharge instructions.
- Be tolerating liquids without nausea or vomiting.
- Rate your pain level as acceptable and controlled with oral pain medications.
- Maintain stable vital signs (blood pressure, pulse, respirations, temperature).
- Be stable and walking safely and/or instructed to appropriately use assistive device.
- Be able to void (urinate) before discharge or receive your doctor's permission to go home without voiding first.
Guidelines To Follow After Being Discharged Home
- The time of your discharge is determined by the anesthesiologist and surgeon with nurse oversight. At the time of discharge, the nurse will review written discharge instructions with you and the person who accompanies you home. You will be given a copy of these instructions to take home and refer to in the days following your discharge.
- Please ask questions if you or your caregiver(s) have any concerns, as it is very important that you and the person responsible for taking you home both clearly understand these discharge and follow-up instructions.
- It is highly advisable that you have another adult with you at home for the first 24 hours after surgery.
- You must not drive, operate machinery, drink alcoholic beverages, or make any important decisions while taking narcotic pain medication.
- You should avoid any drugs other than those prescribed by your physician for at least the first 24 hours. Your nurse will review all your medications including your home medications prior to discharge.
After going home, you will receive a phone call from VVMC to see how you are feeling. Please contact us at any time with questions. There are phone numbers provided on your discharge instructions.
In a few weeks, you may receive a patient satisfaction survey as part of our ongoing quality improvement program. Please take the time to share comments regarding your experience at Vail Valley Medical Center. We are interested in your feedback and share them with our staff in an effort to continue to provide the highest quality of care with excellent outcomes.
Important Phone Numbers
Pre-Surgical Planning: (970) 479-5144
Admissions: (970) 479-7261
Insurance Support Team: (888) 652-7640 or (970) 777-2902
Office hours are from 8:00 AM to 5:30 PM, Monday-Friday.