Patient Guide to Surgery
SURGICAL CAREDATE OF YOUR SURGERY:
Please remember to bring this booklet
with you to your surgical procedure andto all follow-up appointments with yourdoctor following your procedure.

400 W 7 th St | Frederick, MD 21701 | 240-566-3300 | frederickhealth.org

Welcome to Frederick Health Hospital
Perioperative Services
As a patient, you are the most important part of healthcare. This guide was developed with you in mind and provides
materials to help you make the most of your surgical care experience. It offers information about how to prepare forsurgery, as well as what to expect during a hospital stay and after you are released from the hospital. The tools havebeen separated into sections so they can be used at the right times during your surgical experience.
This guide is part of a toolkit for you and all of the partners in your healthcare, including your family, doctors andnurses, hospital, health plan, and your employer, to help prevent Surgical Site Infection (SSI), the most common
preventable complication from surgery. Each of these groups has a stake in your health and your healthcare. By
working together, we will help you have the best surgical outcome possible.
This book was created for you by the Safe Surgery Initiative task force at Frederick HealthHospital (formerly Frederick Memorial Hospital), 2016

Before Surgery

Pre-Admission Screening
Prior to surgery, you may need to speak with up to threeFrederick Health representatives:• The Registration department to pre-register(240-566-4150); you can also pre-register online
at frederickhealth.org• The Imaging Scheduling Center to pre-register(240-566-3400 or 800-995-1438)• The Pre-Admission Screening Nurse (240-566-3918)
One of our Pre-Admission Screening nurses will call you 3-5 days before your surgery. The call usually takes
15-20 minutes. Calls are shorter if you have already set up an account on our patient portal and filled inyour health history.
If we have your email address on file, our patient portal web company (ePREOP) will invite you via email tocreate a patient portal account. All patient information in the portal—including name, address, and contact
details—is confidential and secured by industry-standard encryption technology. If we do not have youremail on file, please visit frederickhealth.org to create your account. With your account you can complete
your health history online. You are not required to create a portal account, and our nurse will contact
you either way.
If you are not available when the nurse calls, we will leave a message for you to call back before a certain
time with the phone number to reach us. If we are unavailable when you call, please leave a name and anumber where we can reach you. If we do not speak with you before the day of your surgery, we will takeyour health information from your portal account or collect the information on the day of your procedure.
You will be asked to verify your name and date of birth. If you don’t have a portal account set up, we will
ask for your health history so we can document it in our system. Health history questions include height
and weight; medication(s), including type (prescribed, over-the-counter, vitamins/supplements, or herbals),dosage, and frequency; and any allergies and associated reactions. The Pre-Admission Screening nurse will
review with you what medication you should take with water the morning of your surgery. Please bring a listof your medications and the last time/date you took them, including the day of surgery.
You may need tests performed prior to your surgery. You must request that the results be faxed to thehospital at 1-844-461-4690. The nurse will ask you to identify when/where you had preoperative testing or
consultations with medical, heart, or lung specialists, so we can contact them to obtain the information if it
has not been received.
It is important for you to know that you have patient rights, including the right to ask questions, toparticipate in your care, to refuse treatment, and the right to comfort, privacy, and safety.
Your surgical experience is important to us. We look forward to serving and engaging with you as active
partners in your care.

1

Before Surgery

Must-Knows Before Your Surgery
As you get ready for surgery, there are a number of things you must know. This tool will help you tobe better prepared.

1. Control your blood sugar (if you are diabetic)
Blood sugar range should be between 140 and 180 mg/dL before meals, and less than 200 mg/dL twohours after starting a meal. The better your blood sugar is controlled in the days and weeks before andafter surgery, the better you will heal and the less likely you will experience any complications.

2. Quit smoking—quitting helps you heal faster
The longer you remain smoke-free before surgery, the better you will heal. Quitting smoking before yoursurgery is an important step for a successful recovery. Smoking increases your chance of complications
like infection, pneumonia and heart attacks, both during
and after surgery. Most doctors recommend tingsmoking as soon as you decide to have surgery. This
includes electronic cigarettes.

3. Know your medications
Know the names of your medications, the dose and how
often you take it. Ask your doctor if you should take any ofyour medications before your surgery, even if you are told
not to eat or drink anything.

4. Keep warm
Use clean blankets and heat in the vehicle that transports you to the hospital.

5. Take your pre-operative shower or bath (see page 7)2

Before Surgery

MUST-KNOWS BEFORE YOUR SURGERY
Enhanced Recovery After Surgery – patient education
Enhanced Recovery After Surgery (called “ERAS”) is a care plan that was made for you by your Surgery andAnesthesiology Teams at Frederick Health Hospital. This plan is called a clinical pathway. The pathway helps
to prepare your body for surgery, recover safely, and return home as soon as possible after your surgery.
Enhanced Recovery After Surgery, or ERAS, is a patient-centered program for surgical recovery. The
basic principles of this ERAS pathway are to ensure your strength before and after the procedure throughdiet and nutrition, to help provide appropriate pain relief after your procedure, and to encourage earlywalking and exercise. Most importantly, you will participate in every aspect of your care and you can help
determine how your recovery occurs!

Why do we use the ERAS pathway?
The ERAS pathway helps you to recover quickly and lowers the chances of you having any problems after
your surgery. This pathway helps you and your team work together to:• Keep your hospital stay short• Keep your pain level under control• Help you get out of bed and walk within 24 hours• Allow you to eat and drink as soon as it is safe for you• Listen to your concerns and explain things clearly• Make sure you are happy with your care at Frederick Health Hospital

What medications will be used to treat my pain?
The underlying cause of pain is inflammation. Medications that treat inflammation therefore become an
important part of your pain management plan. It is important you take them even if you are not in pain.
This will help cut down the amount of opioids you need, which slows down your recovery. Your surgicaland anesthesia teams will work with you on which combination of medications will be best for you and yourtype of surgery.

3

Before Surgery

MUST-KNOWS BEFORE YOUR SURGERY
What will happen after my surgery?
When you are ready, you will be moved to a post-operative surgical unit in the hospital for your recovery.
It is important for you to get out of bed, sit in a chair, and walk as soon as possible. Do this as often as
you can. Your nurse will help you move around safely. If any bladder catheters or tubes are placed by
the surgeon, they will be removed as soon as possible. Your Frederick Health surgery team will tell you
when you can start drinking fluids and eating solid food. Your team will tell you when it is safe for you
to go home.

Things to do now to prepare
Quit smoking. We encourage you to quit completely. Stop smoking 4 weeks prior to your surgery. If you
feel this will be hard for you, please ask your primary care doctor, surgeon, or anesthesia team member foradvice on ways to help you to quit.
Increase your strength and improve your recovery by walking at least 30 minutes a day before yourprocedure. You will be expected to walk after your procedure also. Exercise before surgery will help you
recover after your surgery. Early mobilization is a core component of all enhanced recovery programs. The
ability to be out of bed and to ambulate is a strong marker of successful early recovery and is believed toprevent complications, including pneumonia and blood clots. Common goals include sitting up on the sideof the bed or in a chair on the evening of surgery and ambulating at least four times per day thereafter.
Other programs prescribe a certain number of hours out of the bed per day.
At least a week before surgery, eat healthy foods to fuel your body with the nutrients that it will needduring surgery. This leads to a faster recovery after your procedure, and a faster recovery may mean thatyou can go home sooner!

4

Before Surgery

Getting Ready for Your Surgery
Checklist for your surgery Complete the checklist on page 9 and bring this entire booklet
with you the day of your surgery.

Important reminders

Food & drink: reminders for adults• Follow the instructions on page 7 forshowering. Use CHG and clean towels.

For pediatric patients up to age 18, please consult your doctor.

• Do not use lotion or conditioner on yourskin or hair.
• We monitor your breathing using a device
that is placed on your finger. If you havenail polish, the polish may have to be
removed from one finger on the day of
your surgery.
• Leave all jewelry and valuables at home.
• Do not wear makeup, perfume, or cologne.
• Make arrangements for someone to drive
you home and stay with you after surgery.
• Stop smoking 4 weeks before surgery,and do not smoke after midnight the day
before surgery. Do not vape, use chewing
tobacco, smoke cigars, or use illicit drugs.
• Do not drink alcoholic beverages 24 hours
before surgery.
• If you develop a cold, fever, or other healthproblem within 48 hours of your scheduledadmission, please call and informyour physician.
• For children having surgery, at least one
parent must be present at all times while
the child is in the hospital.

If you have been instructed by your surgeon to havenothing by mouth after midnight, follow those orders
set by your surgeon.
6 hours prior to your report time, you may eat a pieceof plain toast.
You may consume clear liquids, carbohydrate drinks,
or water as described on the following list. These must
be consumed 3 hours prior to your report time. You
may consume lemon drops or peppermint rounds aspart of clear liquids.
If you consume food, clear liquids, carbohydrate
drinks, and/or water outside of the listed times, this
could cause your surgery to be delayed or canceled.

Medications
If you are taking any medications, ask your physician
in advance if you should take them the morning of
surgery. If you are supposed to take medications themorning of surgery, take them 3 hours prior to yourreport time with clear liquids or water.
Contact your doctor for advice if you are taking any
blood thinners, aspirin, anti-inflammatory medication,
insulin, or diabetes medication.

5

Before Surgery

GETTING READY FOR YOUR SURGERY
Important reminders, cont.
• Frederick Health is not responsible for money or valuables you bring with you. We strongly recommendthat you leave all money at home, unless you have a copay. If it is necessary to bring valuables with you,a locker will be provided for you in the outpatient area. When you arrive for admission, notify your nurse
and arrangements will be made.
• For patients being admitted after surgery: please leave your luggage in your vehicle until you havebeen brought to your post-op room. At that point a family member may bring it to your room.
If you have any questions, call your doctor’s office or Pre-Admission Screening at 240-566-4970.

StarchClear Liquid

1 piece of plain toast

Water (plain, carbonated, or flavored)
Fruit juices (without pulp): apple, white grape juice, or lemonade
Decaffeinated coffee: 12 oz. (0 carbs)
Tea: 12 oz. (0 carbs)
Soft drinks: ginger ale, Sprite®, 7-Up®
Gelatin
Strained tomato or vegetable juice
Sports drinks (Gatorade®, Gatorade 2®, Powerade®)
Chicken or beef bouillon/broth, low sodium, fat free
Honey or sugar
Hard candy such as lemon drops or peppermint rounds
Popsicles without milk, bits of fruit, seeds, or nuts

6

Before Surgery

GETTING READY FOR YOUR SURGERY
Instructions for bathing with chlorhexidine [CHG] wipes
What are CHG wipes?
2% chlorhexidine (CHG) wipes are antiseptic (germ-killing) cloths used to wash the skin. The living skin is aconstant source of germs. CHG kills 99% of the germs on the skin to help prevent germs from getting into
an open wound or your bloodstream and causing serious infection.

When should you NOT use these wipes?
Do not use on children under two months of age.
Do not use these wipes if you:• Have an allergy to CHG• Currently have severe skin breakdown, rash, or burns• Are receiving radiation therapy• Are receiving thiotepa (a chemotherapy drug)

When should you use these wipes?
Ideally, use the wipes following a normal bath or shower, but they may also be used instead of a bath/shower. It is important for you to use them before going to surgery. Do not touch your eyes until you wash
your hands after you use the CHG wipes.

How to use the wipes*
1. Wash your hands with warm soapy water or use hand sanitizer.
2. Wipe the cloths using a circular or back and forth motion over the surface
to be cleaned. Wipe each area thoroughly but do not scrub. Do not use thecloths on the face, head, between the buttocks, or genitals.
3. Use a total of six cloths of CHG wipes.

*Do not attempt todo this bathing
in the tub, as
the bath water
will wash off
the CHG soap.

4. Do not rinse or wipe off the skin after using the wipes. Do not apply lotions, moisturizers, or makeup.
Let the skin air dry. Your skin may feel sticky for a short time as it dries—this is normal.
5. Put on a pair of clean pajamas after bathing. At the hospital, put on a clean hospital gown after bathing(do not put your own clothing back on).
Frederick Health will provide one (1) package of wipes to you for use the night before your surgery.
You will perform another was with one package of CHG wipes in the perioperative area on the dayof your surgery.

7

Before Surgery

GETTING READY FOR YOUR SURGERY

1
1

4

2

2
5

15

3

3

2

2
6
3

3

Use one package (6 cloths) of CHG wipes• Cloth 1: Wipe the neck, chest, and abdomen.

• Cloth 4: Wipe the back, starting at the base of
the neck down to the waistline.

• Cloth 2: Wipe both arms, starting with shoulder
and ending at fingertips, then armpit areas.

• Cloth 5: Wipe right and left hip, followed by thegroin. Be sure to wipe folds of the groin area but
avoid the genitals.

• Cloth 3: Wipe both legs, starting at thigh andending at toes; be sure to wipe behind knees• Cloth 6: Wipe the buttocks. Then wash handswith soap or sanitizer.
8Preparing for Surgery Checklist
PATIENT NAMEPATIENT DATE OF BIRTH

You must complete this checklist and bring it with you on the day of your surgery.

□ Pre-surgical lab work completed□ Pre-registration completed□ Pre-screening with RN completed□ Pre-surgical MRSA test completed
Iodine allergy?

DATE:
DATE:
DATE:
DATE:

Latex allergy?

□ Yes
No
Yes
□ MRSA results received
DATE:□ Patient Education Booklet received DATE:NoMRSA Positive

MRSA Negative

Bathe with CHG Wipes (see page 7 for CHG Wipes Instructions)□ Night before□ Day of surgery in Pre-op□ Nasal antiseptic swab

DATE:
DATE:

DATE:

Bring with you:

□ A list of your current medications, including dose and time taken□ Photo ID□ Insurance card and co-pay, if needed□ Something to read or do while you are waiting□ A copy of your Advance Directives and Living Will if you have them
□ CPAP or BiPAP Machine (sleep apnea)□ Eye glasses case/contact lens container and solution
Continued on next page

400 W 7 th St | Frederick, MD 21701
240-566-3300 | frederickhealth.org

PREPARING FOR SURGERY CHECKLISTInstructions for the day of surgery□ Wear clean comfortable, loose-fitting clothes that are easy to change and will not fit tightly over
the area of your surgery.

□ Remove all jewelry (including piercings), nail polish, and makeup.
□ Take your medications as directed by your surgeon or pre-admission screening nurse with only a
sip of water. If not sure, call your surgeon’s office.

□ Do not smoke or use electronic cigarettes or chewing tobacco.

Day of Surgery

On the Day of Your Surgery
3 hours before your report time, it is recommended to consume 50g of a complex carbohydrate, such as
maltodextrin, in a clear liquid beverage. It must be consumed three hours before your report time.

Carbohydrate
Beverage

Manufacturer

AmountNeededTotal
Maltodextrin
Carb (g) (g)% Carb Calories

Clearfast

BevMD/USA

12 oz

50

50

100

200

PREcovery

EMN Health13.5 oz

50

50

100

200

Ensure Pre-Surgery

Abbott

10 oz

50

50

100

200

Impact AR

Nestle3 6 ozcartons

45

--

31

600

Ensure Clear

Abbott

8 oz

52

0

Boost Breeze

Nestle

8 oz

54

0

86

250

Pedialyte Classic

Abbott

60 oz

45

0

100

175

Powerade

Coca-Cola

20 ozbottle

34-35

0

100

130

Gatorade

PepsiCo

2 15 ozbottles

54

0

100

200

Gatorade Low Calorie G2

PepsiCo

7 12 ozbottles

49

0

100

210

Minute Maid Lemonade

Coca-Cola

12 oz can

42

0

100

150

Minute Maid Apple Juice

Coca-Cola

16 ozbottle

48

0

100

180

Welch’s White
Grape juice

National Grape
Cooperative
Association

11.5 oz

55

0

100

200

Beverages also used

11

240

Day of Surgery

ON THE DAY OF YOUR SURGERY
Special notes• You may have one (1) piece of plain toast 6 hours prior to report time.
• A number of studies show that patients do and feel much better ifthey’re allowed to drink up to three hours before surgery. They use
less IV fluid, have better metabolism, reduce hospital stay, andminimize protein loss through healing. It also reduces postoperative complications.

Contraindications for carbohydrate beverages include:• Your doctor said you must have nothing by mouth
after midnight.
• Having fluid in the abdomen (ascites) that limits the amountof fluid that can be consumed or if patients have been told tolimit their fluid intake due to certain conditions including Congestive
Heart Failure (CHF), End Stage Renal Disease (ESRD), or Addison’s
disease.
• People with Diabetes who use an insulin pump for glucose control or
who is insulin deficient (Type 1 Diabetes Mellitus).
• Difficulty breathing due to fluid in the lungs.
• Difficulty swallowing or neurological disorders such as
Parkinson’s disease.
• Documented medical conditions including achalasia, severe
gastroparesis in which the patient has been prescribed a
prokinetic agent (e.g. metoclopramide), hiatal hernia or severe
gastroesophageal reflux disease (GERD).
• Prior surgeries that involved the gastrointestinal system including
total gastrectomy, partial gastrectomy and/or gastric resection.

Please check with yoursurgeon to ensure you
qualify for the carbohydrateloading protocol basedon surgical history.
This paperwork is NOT for
Bariatric Surgery. Follow
your doctor’s specific plan.
Bowel Preparation: For
those that have beenprescribed a bowel
preparation. Please follow
your surgeon’s guidelines
for Bowel Prep, and include
carbohydrate beverage (fromthe list) 3 hours prior toyour report time.

Important
Remember to have your pieceof toast completed 6 hours
prior to your report time.
Remember to haveyour carbohydrate load
and/or clear liquids
completed 3 hours prior
to your report time.
You may drink water anytime
up until 3 hours prior toyour report time!
Example: Your report timeis 6 a.m. Your toast must be
consumed prior to midnight
and the clear liquids/carbload must be consumed
prior to 3 a.m.

12Day of Surgery

What to Expect When You Arrive
Arriving at Frederick Health Hospital
Patients admitted the morning of surgery should arriveat the hospital Main Entrance (#1 Green) two hours
before the scheduled procedure (or as directed by yourphysician). This ensures that there is adequate time toprepare you for a safe surgical experience.

Admission
You will be greeted by a Frederick Health staff member
or an Auxiliary volunteer. They will check you in on
the computer, and as soon as they receive your room
number, you will be escorted back to the pre-operative
area to meet the staff. A registrar will review your insurance documents, collect copay, obtain necessary
signatures, and copy your ID and insurance cards.
A Surgical Waiting Room staff member or volunteer will explain the computerized patient tracking
system to the person who has accompanied you and provide them with your confidential ID number.
They will be able to follow your progress on the large computer screen in the waiting area as you
prepare for surgery, move to the operating room, recovery area and discharge, or transfer to yourroom. That person will also receive a pager to let them know when they are needed at the desk for asurgeon post-procedure conference.

In Pre-Op
Once you are settled in pre-op, your nurse will again verify some basic information for your safety,
perform a physical assessment, complete required documents, carry out any tasks ordered by yourphysician, and start an IV. You will be visited by your surgeon, your anesthesiologist, and your operating
room nurse. They will answer any further questions you might have and will take very good care of you
throughout your surgery.
One family member or friend may stay with you during your preparation. Once you are ready for theoperating room, other family members can join you and then will be directed to the waiting area when you
go back for surgery.
Although our goal is to begin all of our surgeries on time, sometimes surgeries must be delayed due tounforeseen circumstances. If this happens, your nurse will keep you updated as to the status of a delay.

13Day of Surgery

WHAT TO EXPECT WHEN YOU ARRIVE
Marking the surgical site and clipping hair
If indicated, your surgeon will mark your surgery site by writing directly on your skin the day of surgery.
Don’t be afraid to ask for this; it will remind the surgeon of your correct surgical site. Do not mark thesite yourself. Do not shave the surgical site. Someone will clip the hair the day of surgery in Pre-op
area, if needed.

Antibiotic treatment
Ask your doctor if you will be receiving antibiotic medication before surgery to prevent infection. Most
people receive one dose of antibiotics at the time of the surgery and may remain on antibiotics for a day or
two after surgery, depending on your surgical procedure.

Nasal antiseptic
Thirty percent of people carry bacteria in their nose. You are at higher risk to develop infections from thebacteria. Your healthcare providers will provide you with a nasal antiseptic one hour before surgery to
reduce the bacteria in the nose and reduce the risk of you getting an infection after surgery. You will begiven specific directions the day of your surgery.

Anesthesia
On the day of surgery, the anesthesiologist will discuss your anesthesia options. The type of anesthesia you
receive will depend on the type of surgery you are having or any health conditions you have.
• Regional anesthesia: This is also called a “nerve block.” Numbing medication (local anesthesia) is injected
near the nerve to prevent feeling in an arm or leg.
• Spinal or Epidural anesthesia: Numbing medication is injected in your back to keep you from feelinganything in the lower body and legs during surgery.
• General anesthesia: This type of anesthesia makes you unconscious and unable to feel anything. The
medication is usually inhaled through a breathing tube and injected through a vein in your forearm. Oncethe surgery is completed, the anesthesiologist will remove the breathing tube and wake you up. It is not
unusual to have a sore throat for a day or two after the surgery if you had a breathing tube.
You will need to arrange for a responsible adult to take you to and from the hospital, since you may besomewhat disoriented from the anesthesia. We suggest that you have a responsible person stay with you
the first night following your procedure. Adult patients with children should consider making child carearrangements for children for 24 hours following surgery.

14Day of Surgery

WHAT TO EXPECT WHEN YOU ARRIVE
Medications
During your hospital stay, you may be asked to confirm the medications you are currently taking. This ismeant to keep you safe and should occur during admission, transfers within the hospital, and when you arereleased from the hospital.
Some of your medications may be changed during your hospital stay and others may be added oreliminated. Be sure to ask your physician to explain these changes to you, and don’t be afraid to ask anyquestions you may have about a new medication. Each time a physician or nurse reviews your medications
with you is an opportunity to ask questions.
Source: U.S. Department of Health & Human Services. Agency for Healthcare Research and Quality.
Build Your Question List. http://www.ahrq.gov/questionsaretheanswer/questionBuilder.aspx. Accessed July 27, 2010.

In the Operating Room
You will be wearing a special warming gown and transferredto the OR table for your procedure. Monitoring equipment
will be connected and your anesthesiologist will begin
administering medication through your IV. At the completionof your surgery, you will be transferred to the Post
Anesthesia Care Unit (PACU) for your recovery.
A registered nurse will accompany you through your surgicalexperience, beginning with preparing you for the procedure,
remaining with you through the procedure, and managing
your care afterward.

15

Standard precautions aremeasures that are followed
to protect both you and ourstaff against the transmissionof communicable disease.
These measures involve theuse of protective equipment
such as gloves, gowns,
or masks in conjunction
with good hand washingpractice and appropriate
disposal of contaminatedneedles and waste.

Day of Surgery

Visitor Guidelines
We want to reunite you with your family member or friend as quickly as it is safe to do so,
and we understand that they are important to your recovery. Please share the following
guidelines with the person accompanying you to the hospital.
• Outpatients can have one visitor in the PACU when
the patient is approximately 20 minutes from being
discharged. This person should be the individual who
will be caring for you at home. Discharge instructions
will be reviewed with them as well as with you.
• Clinical discretion will be used to determine readinessof visitors in all departments.
• No children of visitors or patients will be allowed in
the PACU.
• If the visitor is going to leave the surgical waiting
area, they should inform the volunteer to ensure thatthey are present to speak with the surgeon after theprocedure and available to go to the PACU when you
are ready for discharge.

Information for visitors
Hours listed below may vary.
The Coffee Bean is located on
the First Floor.
Monday–Friday 7 a.m.–8 p.m.
Saturday–Sunday 8 a.m.–4 p.m.
Hours may vary.
The Frederick Health Auxiliary Gift Shopis located on the First Floor.
Monday–Friday 9 a.m.–7:30 p.m.
Saturday 10 a.m.–4:30 p.m.
Sunday 1–4 p.m.
Hours may vary.
The Cafeteria is located on the lower levelof the hospital and offers a wide variety ofmeal choices and vending machines.
Breakfast 6:30–10:30 a.m.
Lunch 11 a.m.–2 p.m.
Dinner 4–6:30 p.m.
Soup and Salad Bar 11 a.m.–5 p.m.
Grill Open 6:30 a.m.–8 p.m.
Pastoral Care Services are available 24
hours a day, 7 days a week. Please call theswitchboard to connect.
Free WiFi is available
throughout the hospital.

16

Day of Surgery

Immediately After Surgery
PACU/Recovery RoomAfter receiving anesthesia for your surgery or procedure, you will be transferred to the PACU (postanesthesia care unit), also known as the recovery room. Here the anesthesiologist and operating room
nurse will transfer your care to the PACU nurse for you to continue to recover and wake up. Every patient’s
length of stay in the PACU is different, but on average is usually one to three hours.
The PACU is a critical care unit where a registered nurse will closely watch you. You will have monitors
attached to you to evaluate your blood pressure, heart rate and rhythm, breathing and oxygen levels, andtemperature. You may have oxygen administered to you via mask or nasally. Intravenous fluids and pain
medications will be given as needed. Your surgical site will be examined closely. Most patients remember
very little of their recovery room experience.

Your comfort after surgery is important to us• It is common to experience a sore throat, feel tired, and have aching muscles for up to 24 hours
after surgery.
• You may encounter a very dry mouth. Ice chips and water may be given to you by your PACU nurse, if there
are no contraindications, once you are alert. This feeling usually goes away in a few hours.
• You may experience shivering in the PACU. This will be controlled by your PACU nurse using warm blankets
and/or your warming gown.
• Pain is common after surgery. It is important that you describe your pain using a 0 to 10 scale (0 means nopain, 10 means the worst pain you can imagine). Based on your level of pain, pain medication will be given
to make you more comfortable.
• Nausea and vomiting may occur. It is important that you share any previous history of postoperative nausea
and vomiting or motion sickness with your anesthesiologist prior to surgery.
• Medications may be given to decrease the likelihood of nausea and vomiting symptoms. If nausea andvomiting occur in the PACU, your nurse will administer medications to help relieve it.

17Day of Surgery

IMMEDIATELY AFTER SURGERY
When you are awake, stable,
and comfortable

Just for Children

Outpatients will be assisted to a recliner chair, ambulated
to the restroom if needed, and given something to drink.
It is not uncommon for you to feel dizzy, lightheaded,or have brief nausea when first transferring fromthe stretcher to a recliner. At this point, we will callyour family to be with you and review your discharge
instructions and any prescriptions you may have. If yoursurgeon gave you prescriptions at your preoperative
appointment, please have them filled before the day of
your surgery. Frederick Health has an onsite pharmacy,
should you need or want your prescription fille the dayof your surgery.
Inpatients will be transferred to a hospital room fromthe PACU area when you are awake, stable, comfort ismanaged, and the room is ready. The nurse caring foryou will call the waiting room to inform your family of
your room number and where it is located.

18

When your little one is scheduled forsurgery, you want everything to be as
stress-free as possible—and so do we.
As a general rule, children under five
years of age may have their IV started in
the operating room after they are asleep.
Young children may be accompanied into
the operating room by one parent, whowill be allowed to remain with their child
until they are asleep.
When your child is awake and stable, youwill be called directly back to be withthem in the PACU. If your child is to bedischarged, you may carry them out of
the hospital, or they can have a ride in awheelchair—most children love this part!
You will be escorted to your waiting car
by staff or volunteer.

Day of Surgery

Pain Management
Pain management starts immediately after surgery while you are in the recovery room. It is
important for you to remain comfortable after surgery. Good pain management will help
you recover faster and allow you to get out of bed more quickly. This is important to prevent
complications, such as pneumonia and blood clots.
In order to know how much pain medication to give you, the nurses will often ask you to rate your pain on
a scale of 0 to 10, with 0 being “no pain” and 10 being the “worst pain you can imagine.” Be honest when
you answer. Bearing the pain may limit your ability to move around and increase your risk of complications.

For the best pain management during your hospital stay:• Rate your pain on a scale of 0 to 10 when asked about your pain level using the reference scale
described above.
• Ask for pain medication as soon as the pain begins.
Different pain-control treatments will be used at different times during your hospital stay. Pain medication
may be delivered by IV or by mouth.

19After Surgery

After Surgery
Follow-up and discharge
If you are discharged directly from the PACU, you will receive a phone call from one of our
Perioperative Services nurses within a few days of going home. The nurse will ask how you are feelingand answer any questions you have about your discharge instructions. In the meantime, if you haveany questions concerning your instructions, please call your doctor’s office or PACU/Perioperative
Services at 240-566-3435.

Avoiding problems after surgery: Speak Up
Let your doctor know if you are concerned about a medication,
your IV fluids, or if you are experiencing pain. Doing so may
make all the difference in your care. Let your doctor knowwhat is on your mind, whatever it is. Don’t be afraid to speak
up. It can help save your life!

Set a follow-up appointment with your doctor
Before you leave the hospital, you will be given instructions onwhen to follow up with your doctor. If possible, try to schedule
the appointment before you leave the hospital.

Expected activity—do’s and don’ts
Make sure you know how active you are allowed to be after discharge. Ask your doctor when you may:
• Lift anything (and if you are permitted to lift, how many pounds?)• Drive a car• Exercise• Have sexual relations20

After Surgery

AFTER SURGERY
Medication safety
It is important to keep an up-to-date list including over the counter medicines, supplements, herbals, andessential oils with you and share it with your doctor at each visit.

There are four main elements that should be included on your medication list:
1. What you are taking (name)
2. The strength (for example, number of milligrams) and how much you should take (dose)
3. When to take it (frequency)
4. What it is used for

Wound care
In order to avoid wound infection after surgery, you need to be diligent about wound care and handwashing. By following these tips, you will be less likely to get a wound infection:• Keep the dressing clean and dry.
• Wash your hands thoroughly before changing a dressing or emptying a drain.
• Do not remove the dressing and don’t let anybody touch the dressing or the wound unless otherwise
instructed by your physician.
• Do not probe, pick at, or squeeze your wound.
• Follow your doctor’s instructions for wound care.
• Contact your doctor immediately if you experience any symptoms that may indicate an infection, suchas unexpected pain, chills, fever, excessive wound drainage, increasing redness, or swelling of thesurgical area.

21

After Surgery

AFTER SURGERY
Whom should I call after my surgery?
Call your Surgeon’s office at

SURGEON’S OFFICE NUMBER

for:• Increased redness, drainage, bleeding, or• New rash on your body without• Increased redness and/or warmth of the• A fall that did not result in• Severe pain that is not lessened with rest,• Refills for pain medicine or medicines• Break in the incision• Worsening nausea or vomiting• Fever above 101°F and/or shaking chills• Constipation

odor around the incision sitedifficulty breathing or swallowing

lower leg with increased pain

hitting your headcold therapy, elevation, or medicine

prescribed by your surgeon

Call your Primary Care Provider or Urgent Care for the following:• Treatment of illness, including:• Eye irritation and redness

Colds, coughs, andupper respiratory infections;• Laboratory and blood work
• X-Rays

Sore throat;
Flu and flu-like symptoms;• Refills for home medicines

Suspected urinary tract infection;• Illness that is not related to your surgery• Adult IV hydration• Sore throat• Abscesses• High blood pressure• Sprains or suspected minor broken bones• Sinus pain

• Musculoskeletal injuries• Increased feelings of depression or anxiety• Back pain or joint pain22

After Surgery

AFTER SURGERY

Call 911 or visit the Emergency Department (ED) for the following:• Chest pain or other heart attacks• Sudden severe headaches

symptoms, such as:with no cause• Dislocated joints

Pressure, fullness, squeezing/pain in the centerof your chest• Deep cuts or severe burns

Tightness/burning/aching under the breastbone• A fall that results in hitting your head or

Chest pain with lightheadedness

causing extreme pain

• Shortness of breath• Severe abdominal pain

• Head injury or eye injury• Severe asthma attack• Sudden and severe headache or loss of vision• Loss of consciousness• New rash on your body with difficulty• Severe or worsening reaction to an insect bite,

breathing or swallowing

sting, or medications• Heavy bleeding that won’t stop

• Constant, severe/persistent vomiting• Signs of a stroke, such as:• Sudden weakness or numbness of the face/arm/leg
on one side of the body

• Coughing up or vomiting blood• Poisoning Call Poison Control at 1-800-222-1222
and ask for immediate home treatment advice• Sudden dimness or loss of vision• Domestic violence or rape

• Loss of speech or trouble talking• Feelings of suicide

If you believe a life is in jeopardy, always call 911!

23

After Surgery

AFTER SURGERY
Post-discharge care and rehabilitation
Discharge planning starts when you are admitted tothe hospital. A case manager will visit you during yourhospital stay if you are not able to be discharged home
to your own care. Your insurance and your physicalrestrictions will also play a role in your dischargeplanning. Depending on your surgery, rehabilitation
may be recommended.

Nutrition
If you are discharged to recover at home, you should beaware of the food you should eat to aid your recovery.
Eating well after surgery can affect how quickly you
heal; increasing your water intake and eating more protein can aid the healing process. Foods richin protein include:• Meats, poultry, and fish

• Milk and milk products• Legumes (dry beans and peas)• Grains, some vegetables, and some fruits(provide only small amounts of protein
relative to other sources)• Tofu• Eggs• Yogurt, especially if you havereceived antibiotics• Nuts and seeds
For more information about nutrition, visit cdc.gov/nutrition.

Billing
You may need to pay co-insurance or co-payments at registration. We accept cash, personal checks,
and credit cards.
You will receive additional bills for professional services you received from physicians who are contractors
and not Frederick Health Hospital employees. You may receive additional bills from:• Anesthesiologist/CRNA practice• Surgeons• Pathologists• Radiologists

24

We value your opinion…
Our mission is to to positively impact the well-being of every individual in our community.
You may receive a survey about your stay with us, and we would value your input. Pleasetake a few moments to fill out the survey and return it. Our goal is to be the best, andthat means being consistent and always providing a level of service that exceeds yourexpectations.
Thank you for allowing us to give you very good care!
In accordance with state law and hospital policy, smoking is banned in all areas of Frederick Health Hospital.

400 W 7th St
Frederick, MD 21701
240-566-3300
frederickhealth.org