Outpatient pediatric surgery addresses medical issues in young patients that require surgical intervention but do not need overnight hospitalization. As advances in minimally invasive techniques and anesthetics have made same-day surgeries safer and more efficient, the role of a guardian becomes increasingly vital in outpatient pediatric surgery. Guardians act as advocates, comfort providers, and key participants in the perioperative care of the child, and their involvement can significantly impact the child’s physical and emotional well-being throughout the surgical journey.
The preoperative phase is vital for preparing both the child and guardian for the outpatient surgery, ensuring adherence to instructions like fasting or stopping certain medications. Clear communication with the surgical team helps guardians understand the procedure, risks, benefits, and recovery expectations.
Equally important is addressing the child’s emotional readiness, as pediatric patients often feel anxious about surgery. A guardian’s calm, reassuring demeanor and age-appropriate explanations—using tools like books or videos—can help alleviate fears and give the child a sense of control 1,2.
On the day of the surgery, guardians support their child emotionally, offering comfort and reassurance during preoperative preparations. In addition, they ensure all necessary documents like consent forms are completed accurately and act as the primary contact for the surgical team during the procedure 3.
In the postoperative phase, guardians ensure a smooth recovery in the outpatient setting by following discharge instructions on pain management, wound care, activity restrictions, and signs of complications, which pediatric patients may not be equipped to manage. They administer medications, monitor the child’s comfort, and recognize nonverbal pain cues in younger children. Supporting recovery through proper hydration, nutrition, and rest is equally important. Guardians can also identify and promptly report symptoms like fever, excessive bleeding, or infection to healthcare providers to prevent complications 4–6.
The guardian’s involvement in shared decision-making is a cornerstone of pediatric surgical care. To empower guardians and reduce their anxiety levels, pediatric surgical consultations should aim to provide ample information and improve aim to provide ample information and improve 7–10.
The role of a guardian in outpatient pediatric surgery is multifaceted, requiring a blend of logistical coordination, emotional support, and active collaboration with healthcare providers. Their presence not only comforts the child but also contributes to better surgical outcomes. Empowering guardians with knowledge and resources ensures they can fulfill this critical role effectively, paving the way for a smoother surgical experience for the child.
References
1. Cegala, D., Chisolm, D. & Nwomeh, B. A communication skills intervention for parents of pediatric surgery patients. Patient education and counseling 93, (2013). DOI: 10.1016/j.pec.2013.03.015
2. Lerwick, J. L. Minimizing pediatric healthcare-induced anxiety and trauma. World J Clin Pediatr 5, 143–150 (2016). DOI: 10.5409/wjcp.v5.i2.143
3. Surgical Care For Children | OOSC. https://ooscdm.com/patient-guide/surgical-care-for-child/.
4. Starship Clinical Guideline Feedback. Formsite https://fs4.formsite.com/PuOTCh/ne6jxbqbz6/index.
5. Derieg, S. An Overview of Perioperative Care for Pediatric Patients. AORN J 104, 4–10 (2016). DOI: 10.1016/j.aorn.2016.05.001
6. Hasan, A., Zimmerman, R., Gillock, K. & Parrish, R. H. The Perioperative Surgical Home in Pediatrics: Improve Patient Outcomes, Decrease Cancellations, Improve HealthCare Spending and Allocation of Resources during the COVID-19 Pandemic. Healthcare (Basel) 8, 258 (2020). DOI: 10.3390/healthcare8030258
7. Evaluation of the Pediatric Surgical Patient: Background, History, Physical Examination. (2024). https://emedicine.medscape.com/article/936148-overview?form=fpf
8. Kampouroglou, G. et al. Parental anxiety in pediatric surgery consultations: the role of health literacy and need for information. J Pediatr Surg 55, 590–596 (2020). DOI: 10.1016/j.jpedsurg.2019.07.016
9. Kain, Z. N. et al. Healthcare provider–child–parent communication in the preoperative surgical setting. Paediatr Anaesth 19, 376–384 (2009). DOI: 10.1111/j.1460-9592.2008.02921.x
10. Carlisle, E. M., Shinkunas, L. A., Lieberman, M. T., Hoffman, R. M. & Schacht Reisinger, H. Empowering parents of pediatric surgical oncology patients through collaborative engagement with surgeons. J Pediatr Surg 58, 1736–1743 (2023). DOI: 10.1016/j.jpedsurg.2022.12.029