SURGERY FROM THE EMERGENCY DEPARTMENT
Disclaimer: While the following are ideal before surgery, when your procedure occurs emergently, you may not have time to accomplish everything.
If your ER Physician prescribes surgery then you may need to be prepared within a very quick time period. Depending on the severity of your condition and the last time you ate or drank, your procedure may be scheduled immediately or delayed for your safety. Ask when you will be going to the operating room and what is driving that determination.
LODESTAR SCHEDULED PROCEDURES AND SURGERY
Once a procedure or surgery has been recommended, you can decide if you want a second opinion or if you want to proceed with your physician’s office for scheduling. Most physicians have reserved segments of operating or procedure room time called “block time” at multiple facilities.
1.) Make sure you understand the insurance implication for the surgery location your choose.
2.) We recommend you try to get scheduled early in their block period.
3.) For your safety, you must communicate all health conditions and medications and herbal supplements. These will be reviewed by nurses, your surgeon and your anesthesiologist (the provider who will manage you while you are asleep during the procedure) to ensure it is safe to take you to surgery/procedure.
WHAT TO EXPECT:
Your provider should have a thorough discussion with you where you ask questions regarding the risk, benefits and alternatives and achieve your “informed consent” to receive their recommended procedure/surgery. This discussion must be conducted by the physician. It is not appropriate to receive this discussion and your signature with a nurse.
You may need to come into the facility in the days prior to your procedure to pre-register. This involves verifying your identiy, preparing your paperwork, verifying the insurance coverages and co-pays and other financial arrangements.
Ensure they identify the correct John Smith for the health record and insurance purposes. Double check the accuracy of your name and date of birth on your paperwork and possibly your wrist bands.
They will also Lab tests may be required before your surgery. These may be drawn at the hospital or at an outpatient lab (see outpatient lab tab). Ask for a copy of all lab work performed. Ask questions if you see any lab results are marked abnormal.
Based on your age and health history you may be required to complete an EKG and cardiac clearance from a cardiologist. All these steps are to evaluate how well you will likely tolerate surgery. Ask for a copy of your EKG and Cardiac Clearance. Review your record for any inaccuracy’s regarding your health history. Ask questions if you see anything documented as abnormal.
In some cases, you may be required to obtain a dental clearance as well. Ask for a copy of these results.
Prior to your surgery, you will be contacted regarding which medications to continue to take as well as which medications to hold until after the procedure/surgery. Some supplements and medications can “thin your blood” or possibly interfere with anesthesia itself and may need to be held for a certain number of days prior. Oftentimes your cardiologist will be the person providing these instructions.
It is imperative that you don’t eat or drink after some point many hours before your procedure/surgery. Midnight the night before is a common “NPO” (nothing by mouth) time for morning procedures/surgery. Your provider will inform you of your specific time.
If your procedure/surgery is site specific (e.g. left leg or right arm) it must be noted on the consent form. ASK TO SEE THIS FORM AND MAKE SURE IT IS CORRECT.
On the day of the procedure, your surgeon must physically to mark your skin indicating the correct side. We recommend you mark “not this side” in the healthy side. Both the The surgeon and you should will sign the correct side and you should be an active participant in this process. IT IS NOT APPROPRIATE FOR ANYONE OITHER THAN THE PROVIDER WHO WILL BE PERFORMING THE PROCEDURE ON YOU TO MARK THE SITE.
The surrogate decision maker (who will make decisions for you while you are under anesthesia) should be disclosed to the surgeon and present at the facility while you receive your procedure. This person should be active in surgery planning process and will receive information directly from the surgeon after your surgery is completed and before you are completely awake.
Common questions your surrogate should ask physician after surgery is complete
Were there any complications?
Did anything occur that was unexpected?
What was the total blood loss during the procedure?
What are the activity expectations for today and the next couple of days?
Are there any dietary restrictions?
Have you authorized all home medications to be resumed? Or should some not be resumed yet?
What should I watch for and encourage as a support person postoperatively?
For post-surgical guidance, see the inpatient tab and your specific diagnosis.