Preoperative Surgical Admission Patient s Guide fo Preoperative Surgical Admission

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1 Surgery Date: Estimated Arrival Time: Confirmed Arrival Time: UC San Diego Medical Center, La Jolla, 9300 Campus Point Drive, La Jolla, CA Please check in at Main Admissions on the 1st floor UC San Diego Medical Center, Hillcrest, 200 West Arbor Drive, San Diego, CA Please check in at Main Admissions/Patient Access desk, South Wing, 1st floor. UC San Diego Sulpizio Cardiovascular Center, 9434 Medical Center Drive, La Jolla, CA Please check in at the Admissions Desk 2nd floor The time written above is an estimate of when you will need to check-in for surgery. If you have any questions regarding your arrival time, please call Preoperative Surgical Admissions at Hillcrest at (619) Preoperative Surgical Admissions at Thornton at (858) or Sulpzio Cardiovascular Center at (858) The following must be completed BEFORE your surgery: TO LEARN WHAT YOU WILL NEED TO KNOW BEFORE AND ON THE DAY OF YOUR SURGERY, WE RECOMMEND THAT YOU WATCH THE 2 VIDEOS AS DESCRIBED BELOW. UC San Diego Health System has 2 videos available for you to review prior to your surgical procedure. Before Surgery and After Surgery cover detailed information about your surgical experience at UC San Diego Health System. The videos can be accessed by going to the following web address: The videos can also be viewed via You tube by search UCSD Before Surgery and After Surgery. Preparing for Your Surgery For any questions about insurance coverage or other financial issues, please contact our Admissions/Patient Access Representative: Check with your doctor if you are taking aspirin, ibuprofen, or any products that contain aspirin or ibuprofen (Advil, Motrin, etc.) and find out if you need to stop these before your surgery. If you smoke, please do not smoke for at least 24 hours prior to surgery. Please be aware that UC San Diego Health System is a non-smoking facility. On the day before your surgery (until midnight), you may eat normally and take your prescribed medications, unless your doctor has told you differently.

2 Preparing for Your Surgery (continued) DO NOT EAT OR DRINK ANYTHING AFTER 12:00 MIDNIGHT BEFORE SURGERY, including water, gum and hard candy. This is very important! Your surgery will have to be cancelled if you eat or drink anything after midnight. If your doctor has told you to take any medications after midnight, you may do so with a small sip of water. Please remove all jewelry and piercings prior to coming to the hospital. Please leave your valuables at home. Bring your picture ID and your insurance card. If you have a Durable Power of Attorney For Health Care, please bring a copy. Please be sure to arrange for an adult to drive you home after your surgery. Your surgery will be canceled if you have not arranged this! For your safety, you should not use bus transportation. You may take a taxi home only if a responsible adult will be able to ride with you in the taxi. If you have a cold, fever or any other condition that may require your surgery to be rescheduled, please call your surgeon. After hours or on weekends, contact your surgeon by calling UC San Diego Health System s Message Center at (619) On the Day of Your Surgery It is important to shower or bathe before coming to the hospital. Please remove all makeup and nail polish; the doctors and nurses need to be able to see your natural coloring. Wear comfortable, loose-fitting clothes and low-heeled shoes (for example, a big sweatshirt/blouse, sweatpants, shorts, tennis shoes or sandals). Women who are having arm or hand surgery, may find it more comfortable to have a bra that fastens in the front. If you wear glasses or contact lenses, they will have to be removed before surgery. Please bring a case for them if you decide to wear them to the hospital. When you arrive at the hospital on the day of your surgery, please check in at the Admissions/ Patient Access main lobby desk. You will be asked to show photo ID at the time your patient identification armband is placed. Your copay/deductible is required on the day of surgery. We accept cash, check or credit card. Please leave valuables at home,including jewelry, credit cards and money (except your copay for discharge medications). Jewelry must be removed before surgery, including watches, earrings and necklaces. Remember, an adult must come with you to the hospital to drive you home. You will not be able to drive for at least 24 hours after the surgery. Please arrive on time so that you will be ready for your surgery at the scheduled time. If you think you may be late, please call Preoperative Surgical Admissions at (619) as soon as possible.

3 On the Day of Your Surgery (continued) Relatives and friends may wait in the Surgical Waiting Room. They will be contacted by a staff member of the Post Anesthesia Care Unit (PACU) when they may visit you. Because space is limited, we ask that only two people come with you to the hospital. Only one visitor or family member at a time will be allowed into the PACU to visit you. Please tell your relatives and friends who are waiting for you to let the receptionist at the Preoperative Surgical Admissions desk know where they will be waiting and to provide them with a cell phone number, if possible. Your Surgical Procedure You will be taken to a room, where you will change into a hospital gown. Your clothes will be stored in a bag. Please leave your valuables (watch, jewelry and credit cards) at home! The nurse will take your blood pressure, heart rate and temperature, and prepare you for surgery. If you require anesthesia during your procedure, you will meet with a member of the Anesthesiology Department. An IV catheter (a small tube that goes into a vein to give you fluids and medication during surgery) will be placed in your arm at this time. The anesthesiologist and surgical nurse will move you to the operating room. They will stay with you throughout your surgery. The length of time in the operating room will depend on the type of surgery you are having, as well as your individual condition. After your surgery is over, the surgeon or nurse will go out to talk with your family and friends who are waiting in the Surgical Waiting Area. You will be taken to the PACU to recover. In the PACU, a nurse will monitor your heart rate, blood pressure, breathing rate and temperature. How long you stay in the PACU will vary, but will probably be from 1 to 4 hours. The PACU staff will call the receptionist to keep your relatives and friends informed about your progress. Discharge Instructions for Outpatient Surgery When you are fully awake and ready for discharge, you will be able to change into your clothes. The PACU nurse will review your discharge instructions and medications with you and a family member. Please ask your nurse any questions at this time. Because the effects of your anesthesia or medications will not completely wear off for about 24 hours, we strongly recommend that you: Have an adult stay with you for the first 24 hours after your surgery. Take only the medications prescribed by your doctor. Do not drink alcohol for at least 24 hours. Start with a liquid diet and soft foods, as tolerated, for 6 hours before returning to your normal diet unless you have been told otherwise).

4 Do not drive a car or operate heavy machinery for 24 hours. Be careful climbing stairs or using sharp objects. Do not make any important personal or legal decisions for 24 hours. If you had surgery on your arm or leg, you may have numbness for up to 24 hours afterwards. You should avoid extreme temperatures (hot water) and be aware of positioning your arm or leg using a secure method. If you have any concerns about your medical condition after you arrive home (fever, chills, severe nausea/vomiting, bleeding or severe pain), please contact your surgeon by calling UC San Diego Health System s Message Center at (619) If you have left the San Diego area, go to the nearest emergency department. Information for Admission to the Hospital After Surgery If your doctor decides that you need to stay in the hospital after your surgery, you will be taken to your room after a stay in the PACU. When you arrive in your room, you will be greeted by a member of your patient care team. You will be asked to take deep breaths and use the incentive spirometer (a device that helps you take deep breaths). This will exercise your lungs and help prevent lung infection like pneumonia. Your patient care team will help you with activities that will promote good blood flow and prevent blood clots. These activities include turning side to side in bed, ankle and foot rotation exercises, and walking in the hallway. Pain Management While we cannot make surgery completely pain free, your doctors and nurses are dedicated to decreasing your pain following surgery and making you as comfortable as possible. Optimal treatment of pain can speed your recovery from surgery and shorten your hospital stay. Below are some of the ways we use to control your pain. Intramuscular or intravenous injections (pain shots): You may not be able to eat or drink right after surgery, depending on the type of surgery performed. During this time, you will be given pain medication by injection or through your IV catheter. Oral pain medication (pain pills): Once you are able to eat and drink, your pain may be treated with oral medications (pain pills). Since pills take longer to work than pain shots, it is important to let your nurse know about the pain before it becomes severe.

5 Pain Management (continued) Patient controlled analgesia (PCA): PCA uses a machine that allows you to control when you receive pain medication. Instead of calling your nurse when you have pain, you just push a button; this will tell the machine to give you a certain amount of pain medication through your IV. The machine is programmed so that you cannot give yourself too much medication. Epidural catheters: Epidural catheters are used to provide pain relief after surgery in the chest, abdomen or legs. Pain nerves from these areas travel through nerves in the back and spine. By delivering pain medication near the nerves in the epidural space, the pain signals are blocked with a very small dose of medicine. Before or during surgery, a small plastic tube is inserted in your back. During and after your operation, pain medication is given through this tube. Most patients have few side effects. Regional nerve blocks: Regional nerve blocks are used to provide pain relief to a specific area of your body. By delivering medication to the nerves that supply a specific area of the body, the feeling of pain is greatly reduced. Before or after surgery, medication is placed under the skin near the nerves that supply the area of your body where the surgery will occur. The area that the medication is supplied to may even feel numb and you may not be able to move that area of your body for several hours after your surgery. Your anesthesia provider will speak to you before your surgery if this type of pain management is appropriate for you.

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