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Day of surgery - Northwick Park

 
Below you will find information on the day of surgery for adult patients at both the Central Middlesex Hospital Surgery unit (ACAD Centre) and the Theatre Admissions Unit (TAU) at Northwick Park.


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The Central Middlesex Hospital Surgery unit (ACAD Centre)

On the day of surgery
You will arrive at the ACAD centre. When you arrive, the receptionist will welcome you and complete your registration details. You will be directed the pre-operative area (Area 6, Level 1) where the nurses will then prepare you for surgery. They will take your pulse and blood pressure and also go through your medical history.

You will be asked to remove all clothing for surgery. This includes your socks, underwear, dentures, glasses, contacts, hair pins or clips, body piercings and jewellery. You are not allowed to keep any pierced jewellery on during surgery. We suggest that you do not bring these to the hospital; please also do not bring any valuables or items that you don't want to lose. In place of your clothing, you will be given a theatre gown to wear that opens in the back.

An anaesthetist will interview you to ensure you are fit for surgery. You will also talk to your surgeons again. Consequently, you will have a chance to ask any questions you might have. The surgeons will explain the procedure to you and will obtain your consent if this has not already been done.

In the meantime your family will be asked to wait for you in the main reception area.

The length of time you are in surgery and recovery depends on the procedure you are having, the type of anaesthesia you choose, and your physical response to both. However, everyone is required to stay at least one hour after surgery in the recovery room. Your surgeons may be able to give you an estimated length of your stay time when they talk to you pre-operatively.

Once you are in the anaesthetic room, your anaesthetist will place heart monitor pads on your chest, a blood pressure cuff on your arm, and an oxygen saturation probe on your finger. None of these hurts. If the operation involves a general anaesthetic, an intravenous drip will be placed in your arm and you will be induced to sleep by means of both anaesthetic gases (via a face mask) and anaesthetics passed into your veins.

Following surgery
Immediately after surgery all patients will first recuperate in the recovery area. In the recovery room, nurses will continue to monitor your vital signs. Most patients do not have much pain after surgery. If you do have pain, simply tell the nurses caring for you and they will give you medication to make you more comfortable. Visitors are not normally permitted in the recovery room. This is because there will be many patients being cared for in a small area and we must respect everyone's privacy.

Once you are more stable you will be transferred to different areas depending on whether you are a Day Case or not.

If you are a Day Case, you will be transferred first to the Second Stage Recovery Area where you can eat and drink something. This allows you to recover more fully and allow us to further observe you. Thereafter you will be moved to the Discharge Area where your relatives will be allowed to see you and you will be given instructions and taken home medications before your discharge.

If you are not a Day Case (require an overnight stay as an inpatient) you will be transferred first to the Step-down ward where you will recover more fully and your relatives will be able to see you. Thereafter you will be moved to the main wards.

Anyone undergoing general anaesthesia may experience a sore throat after surgery. This is due to a tube that the anaesthesiologist introduces to your windpipe during surgery. This tube is for your protection to control breathing during surgery. It is very important that you don't have anything in your stomach when this tube is being placed. That is why we ask you not to eat or drink anything after midnight the night before you surgery. The only exception is your routine medication which may be taken, at the usual times, with a sip of water.

We hope this has answered some of your questions and alleviated anxiety. Our goal is to make your road to surgery and recovery as easy as possible. If you have any further questions, the nursing staff and surgeons will be glad to answer them on the day.

There is no ENT doctor cover after 5pm or weekends at the ACAD centre or Central Middlesex Hospital. If you feel unwell and in need of advice please contact ACAD on 020 8963 8931 or 020 8963 8873.

If you need to return to hospital, please contact Northwick Park Hospital on 020 8864 3232 and ask to speak to the ENT doctor on call, or attend your local A&E department.

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The Theatre Admissions Unit (TAU) is a purpose built unit caring for elective day case and short stay surgery for adults. We have three floors:

  • Level 2 – Reception and Pre-Assessment
  • Level 3 – Day Care
  • Level 4 – Short Stay.

We have a team of dedicated nurses and healthcare assistants to ensure that your stay is as comfortable and efficient as possible.

The day before surgery

  • If you were seen in the pre-assessment clinic prior to surgery please read through all the information received and ensure you follow the ‘Nil by Mouth’ instructions you were given

  • If you were not seen in pre-assessment please follow the guidelines below:
    • For morning surgery, do not eat after 2am on the day of surgery although you may drink water until 6am
    • For afternoon surgery you may have a light breakfast such as tea and toast at 6am and may drink water until 11am
    • DO NOT chew gum whilst nil by mouth.

In some cases you may need to be admitted to a ward the day before your surgery- this would be discussed with you at your pre-assessment appointment.

On the day of surgery
Please follow the fasting instructions you received and please bath or shower prior to admission.

Patients should report to the Pre operative area on Level 2 of the Theatre Admissions Unit, Northwick Park Hospital. Some theatre lists run all day so it is difficult for staff to predict what time your surgery will take place or what time you will be discharged.

On arrival the receptionist will check your details and direct you to the appropriate area. The nurse will record your Blood Pressure, Pulse, Respirations and Temperature. You will be asked questions to ensure you are fully prepared for surgery. You will need to undress and put on a hospital gown. You will be provided with surgical stockings to reduce the risk of Deep Vein Thrombosis (Blood clot in a deep vein, predominantly in the legs). You will see your surgeon who will explain the operation to you and ask you to sign a consent form. You will also see your anaesthetist who will discuss the anaesthetic with you.

You will need to remove all jewellery and body piercings prior to surgery except for a wedding band which will be taped for safety. We recommend these items are removed and left at home. Any nail varnish should be removed from fingernails and if you have acrylic nails please remove your nail varnish prior to admission.

Please only bring a small amount of luggage with you. If you are having day surgery you only need a dressing gown, slippers and a book/magazine. TAU has a small safe which you may leave your mobile phone in whilst in surgery.

If you are staying in hospital overnight please only bring a small holdall with the above plus toiletries. If you are staying in for a few days you will be transferred to a ward post-operatively. It would be helpful if your relatives take your property home and bring it back to you once on the ward.

You may bring one relative with you. They may wait with you until you go into theatre. We recommend relatives go home at this time and phone for information later, however waiting rooms are available.

In place of your clothing, you will be given a theatre gown to wear that opens in the back.

Your family will be allowed to wait with you until you are due to go to the operating theatre.

An anaesthetist will interview you to ensure you are fit for surgery. You will also talk to your surgeons. Consequently, you will have a chance to ask any questions you might have. The surgeons will explain the procedure to you and will obtain your consent if this has not already been done.

When it is time for your operation, a nurse will check your details again. You will be escorted into the anaesthetic room where you will be connected to some routine monitoring machines.

Post surgery 
You will wake up in the recovery room. The recovery staff will continue to monitor your observations and ensure that you are comfortable. Once stable you will be transferred back to TAU, Post-operative area in ACAD or one of the wards. You will continue to be monitored until you are ready for discharge.

Please note, if you have day surgery under General Anaesthesia you must have a responsible adult to collect you and stay with you for 24 hours post-anaesthesia.

Anyone undergoing general anesthesia may experience a sore throat after surgery. This is due to a tube that the anesthesiologist introduces to your windpipe during surgery. This tube is for your protection to control breathing during surgery. It is very important that you don't have anything in your stomach when this tube is being placed. That is why we ask you not to eat or drink anything after midnight the night before you surgery. The only exception is your routine medication which may be taken, at the usual times, with a sip of water. We hope this has answered some of your questions and alleviated anxiety. Our goal is to make your road to surgery and recovery as easy as possible. If you have any further questions, the nursing staff and surgeons will be glad to answer them on the day.

You can contact the Theatre Admissions Unit on 020 8869 3132 Monday to Fridayfrom 8am - 8pm.

Outside of these hours, please contact Northwick Park Hospital on 020 8864 3232 and ask to speak to the ENT doctor on call, or attend your local A&E department.

In an emergency please go to your nearest A&E or dial 999.