Dedicated Paediatric Unit

Welcome to St John’s Hospital Simpson Unit

Your child has been booked into Simpson Unit for their upcoming surgery. Simpson Unit is the dedicated Paediatric Unit for Calvary Hobart so we like to ensure your child is cared for with their needs in mind. In order to make your child’s admission as smooth and stress free as possible we have put together some information for you to read in the days/weeks prior to your visit to hospital.

A child that is prepared is better equipped to deal with the theatre process so it is important to explain to your child (in age appropriate language) about their upcoming trip to hospital.

To assist in easing any of your child’s or your concerns about your upcoming hospital visit you are able to visit the Paediatric area from 3:30pm – 4pm on Tuesdays and Thursdays for a guided tour. This will help your child be more familiar with the environment. Please ring Simpson Unit on
6220 3727 to arrange this with one of our nurses.

We have also prepared a video which is available through the Calvary website. The video shows you and your child the admission process and what is involved in going to theatre. It is suitable to show your child as part of preparing them for admission.

The doctor’s rooms will provide you with an admission time for hospital. Please ensure you have checked and have acknowledged the time of admission.

It is also important for you to start to think about how you will manage the hospital admission, especially if you have other children that may need to be organised or left in the care of trusted family or friends.

Your doctor’s rooms should also indicate to you when your child should fast from. Fasting involves not having any food or fluids from the time indicated by your doctor. If you are unsure you can call your doctors rooms or Simpson Unit the day before and we can clarify fasting times for you. Please do not let your child sleep past their fasting time if you are instructed to give them an early breakfast as it may be a long time until they return from theatre and are allowed to eat and drink again.

Begin to discuss with your partner/family member that might be accompanying you into hospital with your child, who would like to be the support person for your child going off to sleep for the procedure in theatre.

Please, if your child is unwell in the days prior to the operation let the doctor’s rooms know or alternatively let the hospital know if it is after
hours/on the weekend.

Please explain to your child that taking medication is important whilst in hospital to help them feel better and recover. Medication is usually given in a syringe as a liquid and squirted into the child’s mouth and we do try to make it as easy as possible for all concerned. If your child is aware of this then they usually take medicines more easily.

Once again ensure fasting has occurred as indicated by your doctor.

Your child might feel comforted by a favourite soft toy/game etc. so bring it with you into hospital.

A teddy is welcome into the theatre to accompany your child. Please bring anything else that might keep your child entertained.

Please bring any documents you have been asked to complete for this admission.

Please bring details of your child’s medical history including any allergies and medications they may be taking. If your child requires an Epipen please make sure this is with you.

Please bring sleepwear if your child is staying overnight and a change of clothes.

Please bring toiletries/nappies or dummies or soothers.

Please bring milk formula, bottles and or favourite feeding cup.

Car parking is available on site at the front and rear of the hospital.

You will have been given an admission time by your doctor and it is important to present to the reception desk at the designated time to ensure we have your child admitted in a timely manner. This allows reception and nursing staff to attend to your child before the anaesthetist visits on the ward.

On admission nursing staff will admit your child. This will include taking their blood pressure, temperature, oxygen levels and heart rate (observations). The nurse will also prepare your child for theatre and this is your opportunity to ask any questions you may have.

If you require a medical certificate for the period your child will be unwell please ask nursing staff on admission so they can bring this to your doctor’s attention.

You will be asked to complete a menu for your child and yourself and if either of you have any special dietary requirements please let us know.

Your anaesthetist will visit your child on the ward to assess them prior to the anaesthetic.
It is important to share any medical history with the anaesthetist at this time. The doctor may ask nursing staff to give your child a premed which is usually a dose of paracetamol. On rare occasions the premed may consist of a medication to help relax your child before theatre.

We will check on fasting times as it is vital that your child has an empty stomach to prevent any possible complications during the anaesthetic.

A local anaesthetic cream may be applied to the back of the child’s hand and covered in a clear film dressing. This numbs the area so that intravenous access (a drip) for the anaesthetic is less stressful.

Your child will have an IV cannula into their hand or arm. This is a small plastic tube that goes directly into a vein so that if needed nursing staff can deliver medication or fluids (a drip). This cannula is taped and bandaged and remains in place for your child’s entire stay. The cannula will be removed just prior to discharge from hospital.

Your child will be asked to dress in a theatre gown but if they become distressed by this we just take the gown to theatre. They will travel to theatre on a trolley or be carried by you. Some days there will be a hospital volunteer working in the paediatric area to support you and your child during the immediate pre and post-operative time.

You will be able to escort your child into theatre until they are under anaesthetic and will be asked to don a theatre cap and gown as you enter the theatre complex.

Once your child’s surgery is complete they will wake in Recovery room. When they are adequately awake you may be asked to attend to them and nursing staff will escort you to your child. When your child is awake enough and comfortable they will be brought back to the ward to recover.

Occasionally a child may experience what we call emergence delirium. This means that a child may wake from the anaesthetic extremely distressed. This may involve them thrashing about, screaming and crying and you will be unable to reason with them. Usually this subsides within 30 minutes and it is important to just keep your child safe during this period. Often they will not want to be cuddled or nursed so just try and distract them during this period and nursing staff are there to assist you. This can be extremely distressing for parents but once this period is over the child recovers well. Your child is unlikely to remember this experience.

If the surgery is a day case then the minimum time you will need to stay on the ward is 2 hours. During this time we continue to check your child’s observations, give them something to eat and drink and ensure they have no post-operative pain. A sandwich will also be available for you and tea and coffee making facilities are available. Your child will then be discharged with instructions from the doctor and any medication that may be required will either be available ready for discharge or a prescription will be given to you.

If your child is an overnight stay, one parent is able to stay with them and a sofa bed will be provided. Meals will be provided for you and your child, however we ask that you attend to your own breakfast the following morning in the kitchen on the unit. Toast and cereals are available as well as hot drinks.

During an overnight stay the length of observations will increase significantly and it may require Oxygen Saturation level monitoring overnight. This involves popping an adhesive tape over your child’s finger or toe so that we can monitor their levels of oxygen whilst they are asleep.

During your stay nursing staff will also monitor the need for pain relief, it is important to ensure your child is as comfortable as possible so please do not hesitate to ask your nurse if you feel your child is in pain.

Visitors – family and friends are welcome to visit the unit at any time but we ask that they check with nursing staff on arrival to the ward.

If your child is a day case they will be discharged once they have recovered from their anaesthetic and this is usually between 2 and 4 hours after returning to the ward.

If your child is staying overnight they are usually reviewed by the surgeon the next morning. This is an opportunity to ask any questions you may have.

Discharge is usually shortly after this visit and before 10am.

You will be given instructions by your nurse on caring for your child after discharge and it is important that you follow their advice. Written information may also be provided depending on the surgery. Any discharge medications or prescriptions will be provided to you.

If your doctor has failed to provide a medical certificate this can be obtained from their rooms and most are happy to send this via email or post.

After discharge if you have any concerns regarding your child’s recovery we advise that you contact the doctors rooms or present to the Emergency Department at the Royal Hobart Hospital as they have paediatric doctors on duty. You will be given a card on discharge with contact details for the RHH.

Kids and Parents, watch our 5 minute video about coming to hospital