Pediatric Surgery Checklist
Pediatric Surgery Checklist
Before Day of Surgery
- I know when to arrive at the hospital.
- I know what time to stop eating and drinking.
- I have planned care for my other children and pets.
- I have cleaned any cloth comfort items that we will bring to the hospital (blankets, stuffed animals).
- My child had a shower or bath. We followed the special instructions from the clinic.
- If my child is ill, I will call the surgical provider’s office.
Day of Surgery
- We followed any special instructions from the clinic.
- We have a second pair of clothes and underwear.
- My child has removed all contacts, retainers, nail polish, tampons, and jewelry (including piercings).
- My child is not wearing makeup, nail polish, powders, lotions, antiperspirants/deodorants, or glitter.
- Comfort items for my child: pacifier, bottle (for after surgery only!), blanket, stuffed animal, books, magazines, electronic devices (with headphones), etc.
- Things to do while I wait: book, magazine or electronic device (with headphones).
- A complete list of medicines that my child takes (or photos of bottles)
- Special equipment (inhaler, glucometer, CPAP, ventilator or tracheostomy supplies) your child may need during the recovery process after surgery/procedure.
- Medical and prescription insurance cards
- Money or credit card for food, parking, co-pays
- Photo ID for all adults coming to the hospital
- Foster parents, guardians: Proof of legal guardianship
- Nursing mothers: breast pump and supplies
- An overnight bag, if we have to stay the night
Child's Checklist
- My favorite comfort items are clean and packed (stuffed animal, blanket).
- I have a list of questions for my care team.
- I have a second pair of clothes.
- I have items that will help me feel calm and relaxed.
- I have taken a shower or bath and have clean clothes on.
Print the Checklist
Download or print the checklist here.
