Surgical Services

• Breast Surgery
• Cardiothoracic Surgery
• Colon and Rectal Surgery
• General Surgery
• Hysterectomy Surgery
• Obstetric and Gynecologic Surgery
• Ophthalmologic Surgery
• Oral and Maxillofacial Surgery
• Orthopedic Surgery
• Otolaryngology (Ear, Nose and Throat) Surgery
• Plastic Surgery
• Robotic Surgery
• Urologic Surgery
• Vascular Surgery

It is important to be prepared for your preadmission visit. Wear comfortable clothing, (ie/ a button front shirt and socks for easy access for testing). A registrar will verify your insurance, other information and collect co-payments (if applicable). You must bring the following with you:

• Insurance cards
• Testing results and/or your History and Physical (if you have them)
• Advance Directive/Living Will copy for your medical record (if you have one)

• List of all your current prescription and over-the-counter medicines, including supplements, with dosage.

Check-in

• For cardiac and vascular surgeries, please check in for your preadmission appointment in the Cardiovascular Preadmission Testing department located on the first floor of the Cardiovascular and Critical Care Pavilion.
• For all other surgeries, please check in for your Preadmission Testing appointment located on the first floor of the Ambulatory Center.

The Day Before Surgery

• You will be called with your arrival time by 6pm the working day before the day of your procedure.
• Drink 8 to 16 more fluids (water) than usual the day before surgery, unless you have been told to limit fluids. Do not drink alcohol for 2 days before surgery. Caffeine and alcohol can dehydrate you.
• Do not smoke after midnight the night before surgery. Smoking can delay healing.

The Day of Surgery

Enter via the Hospital Main Lobby. Walk through the lobby, take the elevator on the left to the second floor and turn right. Check in with the volunteer at the desk. If having a cardiovascular procedure, enter through the Cardiovascular and Critical Care Pavilion.

If you have any health changes between your last visit to your surgeon and the day of surgery, tell your surgeon. These include a fever, sore throat, cough or cold. If you think that you may be pregnant, tell your surgeon.

Visitors

For the comfort of all patients and visitors, we ask that only one visitor be at your bedside. Both parents of children that are having surgery are allowed. Please have other children under 16 years of age cared for at home.

Services/ Special Needs

Non-English speaking patients may use family members as interpreters. For any healthcare discussion or decision, the hospital language line interpreter must be used.

If a patient has special needs (physical disabilities, hearing impairment, is ventilator-dependent or mentally challenged), please tell the Preadmission nurse so that we can plan ahead.

Did you know smoking the morning of your surgery or procedure increases your risk for complications.

Some of the risks associated with smoking cigarettes before surgery include:

• Cardiac (heart) and pulmonary (lung) complications
• Bleeding
• Need for a repeat operation
• Wound infection

Did You Know if you vape, the variety of preservatives, solubilizing agents, and flavors in vaping can cause harmful chemicals to be inhaled into your lungs!

Vaping increases your risk for:

• Pulmonary complications. This includes a severe lung injury called EVALI.
• Cardiovascular (heart and blood vessel) complications such as high blood pressure and heart rate and narrowing of blood vessels.

What can You Do as You Prepare for Surgery?

• Quit or stop smoking for as long as possible before your surgery.
• If you cannot quit, you should not smoke for 12 hours before the day of your surgery.
• DO NOT smoke the day of your procedure.

  Now is a great time to think about your health. Here are some resources to help!

Smoking Cessation Resources

• Smoke Free Government Webste: smmokefree.gov
• American Lung Association: lungusa.org

Group Counseling

• Clearing the Air: 215.710.2264
• Quit Now: 1.800.QUIT.NOW
• Determined to Quit: determinedtoquit.com

Talk with your family doctor about choices to quit. Here are some over the counter options:

Nicotine Patch

If you smoke more than 10 cigarettes a day: 21/14/7 mg regimen

• Apply 21 mg patch once daily for 6 weeks, then
• 14 mg patch once daily for 2 weeks then
• 7 mg patch once daily for 2 weeks

If you smoke 10 or less cigarettes a day: 14/7 mg regimen

• Apply 14 mg patch once daily for 6 weeks then
• 7 mg patch once daily for 2 weeks

Gums and Lozenges

• If you smoke within 30 minutes of when you wake, a 4 mg dose is recommended.
• If you wait more than 30 minutes after you wake to smoke, a 2 mg dose is recommended.

Gums

• Weeks 1 to 6: chew 1 piece of gum every 1 to 2 hours (no more than 24 pieces a day).
• Weeks 7 to 9: Chew 1 piece of gum every 2 to 4 hours.
• Weeks 10 to 12: Chew 1 piece of gum every 4 to 8 hours.

If you have strong or frequent cravings after 1 piece of gum, you may use a second piece within the hour but do not keep taking one piece after another.

Lozenges

• Weeks 1 to 6: 1 lozenge every 1 to 2 hours

  (no more than 5 lozenges every 6 hours; 20 lozenges a day).

• Weeks 7 to 9: 1 lozenge every 2 to 4 hours

  (no more than 5 lozenges every 6 hours).

• Weeks 10 to 12: 1 lozenge every 4 to 8 hours

(no more than 5 lozenges every 6 hours)*

* Do not take any gums or lozenges 2 hours prior to the scheduled surgery time.             

What if You use Cannabis (Marijuana)?

All forms of Cannabis (smoking, vaping, edibles) increases your risk for:

• Cardiovascular complications. You are two times more likely to have a cardiovascular event. The risk for having a heart attack within the first hour of cannabis use is 4 to 5 times higher than those that don’t.
• Pulmonary complications
• Nausea and vomiting and even a severe problem called hyperemesis syndrome.
• A need for a higher level of anesthesia.
• Higher levels of pain and the need for more opioids for pain control after surgery.

What can You Do as You Prepare for Surgery?

• Talk to your family doctor. You may use cannabis for medical reasons. We cannot recommend stopping or continuing it. If you are a chronic (long term) user, you may have withdrawal symptoms such as sleeplessness, irritability, anxiety and depression. Discuss the risks versus the benefit of this treatment with your doctor prior to your surgery.

• Do not use any form of cannabis on the day of surgery because of the very high risk of cardiovascular complications.

Our goal is to care for the special needs of children during their surgical and anesthesia experience. Bringing a familiar toy to the hospital may help your child feel more secure. Assure your child that coming to the hospital is only for a short time and that they will be going back home. Encourage your child to ask questions. Be honest with your answers. For a child under the age of five, two adults are needed for the ride home from the hospital.

Pediatric Fasting Guidelines (Ages newborn to 17 years):

(to follow if no instructions from surgeon)

• May have clear liquids up to 2 hours before your arrival for surgery.
• May have breast milk up to 4 hours before arriving for surgery.
• May have formula up to 6 hours before arriving for surgery.
• No solid foods for 8 hours before arriving for surgery.

(unless you have been given other instructions by your surgeon)

You must follow the fasting guidelines you have been given, or your surgery may be cancelled to avoid life threatening consequences.

• Adult Fasting Guidelines:(if no instructions were provided by surgeon)
  • No solid foods for 8 hours before you arrive for surgery.
  • You may have clear liquids up to 2 hours before you arrive for surgery.
  • NO liquids for the last 2 hours before you arrive for surgery.
  • No chewing gum or sucking candy 8 hours before arrival.
  • You may have a sip of water with medicines that your doctor has told you to take before surgery.
• Skin Conditions: Tell your surgeon if you have any rashes, cuts, sores or skin problems before surgery.
• Download the pre-surgical shower guidelines (adults).
• Jewelry/Piercings: Remove ALL jewelry (rings, earrings, bracelets, necklaces or others) before you are admitted. Piercings worn during surgery increase the risk of infection, may cause damage to your skin and affect circulation.
• Valuables: Leave money, wallets, credit cards and other valuables at home. If you wish to have prescriptions filled before going home, bring your prescription card with a small amount of money.
• Contact Lenses: Remove before surgery. You may bring glasses.
• Hearing aids: Wear them into THE hospital and bring a storage case with you.
• Nail Enhancements: Remove all make up. Remove acrylics, wraps or polish from nails on the side of your surgery (includes arm, shoulder, hand, hip and leg surgery). For spine patients: no toenail polish for back surgery, no fingernail polish for neck surgery.
• Dentures or Mouth Appliances: May be removed before surgery after talking with the anesthesiologist.
• Tampons: Remove before surgery.
• Hair Styling/Make-up Products: DO NOT use these before surgery. This includes hair spray and gels.
• Clothing: Wear comfortable, loose-fitting clothing.
• Cell Phones: Are not allowed in the Critical Care Unit, Cardiac Intensive Care Unit, Operating Room, Neonatal Intensive Care Unit and Catheterization Lab. Please silence cell phones while in the Same Day Surgery unit.
• An Escort Driver: Only people 18 years of age or older can drive you home if you are being discharged the same day of surgery. You should have someone stay with you the first 24 hours after surgery.
• Medicines: Follow instructions provided by surgeon.