what you need to know about having a procedure - Rush University ...

WHAT YOU NEED TO KNOW
ABOUT HAVING A PROCEDURE
www.rush.edu

Additional Instructions From Your Physician
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CONTENTS
Before You Arrive 2
When You Arrive 6
WhAt to expect After Your procedure 7
GoinG home 8
prepArinG Your child for A procedure 9
AdditionAl informAtion 12
GettinG to rush 14
GettinG Around rush 17
Welcome to rush university medical center. our staff realizes
that this can be a stressful time, and we will do everything we can
to ensure that you receive the very best care and that your visit to
rush goes smoothly.
this guide was created to help you prepare for your procedure.
We hope you find this information useful. if you have any
questions or concerns during your time at rush, please speak to
any member of your health care team.
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2
BEFOrE YOu arriVE
MakE SurE all PrE-PrOCEdural TESTiNg iS COMPlETEd
Your doctor or another health care professional will meet with you before your
procedure to discuss routine pre-procedural tests. Your physician will need
to receive the results of all pre-procedure tests at least 3 days before your
scheduled procedure to avoid any delays or cancellations. Your doctor may
discuss these tests with you in more detail.
ExPECT Our CallS
Before you come to rush, staff from the following areas may contact you:
Hospital Registration
A staff member will call to verify your insurance coverage. if your scheduled
procedure is within 48 hours and you have not been contacted, please call the
Admitting/registration department at (312) 942-5700.
Anesthesiology
if you are receiving anesthesia for your procedure, a member of the anesthesia
team may attempt to contact you to discuss the anesthesia plan for your
procedure and answer questions about your prescription medications, anesthesia
and pain management during and after your procedure. You will have an
additional opportunity to speak with your anesthesia team when you arrive
on the day of your procedure, if you are not reached prior to the day of your
procedure.
Perioperative Care Unit (PCU)
A nurse from the perioperative care unit (pcu) will call to review your
health history and instructions for pre-procedural preparation and the time
you need to arrive at rush. if you have questions or have not received a phone
call from the pcu by the day before your procedure, please call (312) 942-5040
prior to 6 p.m. the day before your procedure. if your procedure is scheduled
on a monday, please call on the friday before your procedure. if you have
not received confirmation of your procedure time by 6 p.m., please call
(312) 947-0500 and ask to speak with the operating room charge nurse.
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BEFOrE YOu arriVE
gETTiNg rEadY FOr ThE PrOCEdurE
the following instructions will help prepare you for your procedure and recovery:
Diet
• As a general rule, you should not eat or drink after midnight on the night before
your procedure. under rare circumstances, you may be given permission to have
clear liquids up to a few hours before your procedure.
• Avoid alcoholic beverages for at least 12 hours before your procedure.
Medication
• unless otherwise instructed by your doctor or a member of the anesthesia team,
take your normal morning prescription medications but with only a small sip of
water.
• do not take any vitamins or herbal supplements for at least 12 hours before your
procedure.
• do not take oral diabetes medicines. if you take insulin for diabetes, check with
your doctor about how much you should take the day of your procedure.
• if you take blood-thinning medicines such as coumadin, plavix, aspirin or ibuprofen
(e.g., motrin, nuprin or Advil), ask your doctor if you should stop taking
them prior to procedure.
Other Instructions
• stop smoking at least 2 weeks before your procedure, or earlier if possible.
• Bathe with an antibacterial soap the night before or the morning of your
procedure. do not apply lotions, creams, powders or deodorant after bathing.
• call your doctor before the day of your procedure if you develop a fever, cold
or rash.
• if you are having your period the day of your procedure, do not wear a tampon
(wear a pad).
• Arrange to have a responsible adult escort you home after your procedure.
You will not be allowed to drive yourself home. if you are having an outpatient
procedure, you must have a family member or friend with you after the procedure
to review your instructions and help you home. it is recommended that
your family member or friend remain with you during the first 24 hours for your
safety and protection.
• inform your doctor and the anesthesia team if you have allergies to any
medications or latex.
• patients under 18 years of age must be accompanied by a parent or legal
guardian.
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4
BEforE You arriVE
Pack for Your comfort and EfficiEncY
Please bring the following:
• Photo ID (driver’s license or state ID).
• Insurance card and information.
• List of prescription and non-prescription medications
that you take (see page 5 for form). You may bring
your medications to the hospital, but for reasons of
safety and Rush policy, medications will be supplied to
you by the hospital pharmacy during your stay.
• List of past hospitalizations, illnesses, surgeries,
allergies (and allergic reactions) and immunizations.
• Assistive devices, such as walkers, crutches, canes,
hearing aids and magnifying glasses. Please label all
personal items with your name.
• Names and phone numbers of family or friends to
contact in case of emergency.
• Comfortable clothes to wear home.
• Money to purchase newspapers, magazines or other
items (limit of $10 in cash).
• Copy of your advance directives, if you have such
documents. Advance directives are given to your
doctors and family in case you become unable to
make medical decisions for yourself. Advance directives
include a living will and durable power of
attorney for health care. Any person 18 years of age
or older should be informed about advance directives.
Patients can request copies of advance directives
when they are admitted to Rush. For further information,
call Rush’s Department of Religion, Health and
Human Values at (312) 942-5571.
If staying overnight, you are welcome to bring the
following:
• Robe and slippers.
Leave the Rest at Home
Please leave the following
items at home:
• Valuables such as credit
cards, checkbooks, large
amounts of cash and
jewelry.
• Please remove all jewelry (including
wedding, navel and
nose rings). If you are unable
to remove any of these items,
they will be cut off for safety.
• Personal electrical
appliances, such as hair
dryers, curling irons, electric
shavers, heating pads,
television sets, radios,
cellular telephones and
laptop computers.
We cannot be responsible for
your belongings. If you must
bring valuables, ask the staff
to deposit them in the hospital
safe. Please be aware that
if you need to deposit items
in our safe, your registration
and discharge process will
require extra time. For your
convenience, we strongly
recommend leaving unneeded
items and valuables at home.
• Personal toiletries, such as shampoo, deodorant, toothbrush, toothpaste,
denture cream and moisturizer.
One family member is allowed to stay at your bedside overnight.
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BEFOrE YOu arriVE
MEdiCaTiONS aNd SuPPlEMENTS
please list all medications that you are currently taking and bring them with you to the hospital.
medication/supplement What it is for dosage times taken per day last time taken
name
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kellogg
Jelke
E d
guest
relations
6
MaiN STrEET
WhEN YOu arriVE
arriVal aT ruSh
check in at the time provided by the
scheduling office. this will be 1.5 to 2.5
hours prior to the scheduled start of your
procedure.
if you are parking in the parking garage,
please check in at the admitting/
registration desk, Atrium Building, 1650
W. harrison street, 4th floor. the 4th
floor of the parking garage provides direct
access into the Atrium Building (see map
on page 16). if you are valet parking or
being dropped off, please check in at
the admitting/registration desk, Brennan
pavilion, 1620 W. harrison st., 1st floor.
if you need wheelchair transport,
assistance is available at the valet entrance
of the Brennan pavilion, 1620 W. harrison
street. once you are inside, a member of
the guest relations staff can assist you.
When you arrive at the 4th floor of the
Atrium Building (1) or at the 1st floor the
Brennan pavilion (2), please proceed to
admitting (see maps below). You will
be asked to provide a photo id (driver’s
license or state id) and an insurance card
at this time.
You will receive a hospital wristband
to wear. this wristband serves as
your identification while you are in
the hospital. You will find that this
identification is checked many times while
you are in the hospital. sometimes it may
seem too often; however, this check is
done to keep you safe.
1
admitting
4th floor
atrium
to parking
to tower
admitting
1st floor
2
After you have completed paperwork in
admitting, you will be given directions
to the check-in area of the floor where
you are having your procedure. A staff
member will greet you.
You will then be escorted to the
perioperative care unit (pcu) where you
will have your temperature, pulse, blood
pressure, height and weight taken and
recorded. the nursing staff will review
your chart, and you will change clothing
for your procedure.
if you are scheduled to receive anesthesia,
you will meet with the anesthesia team,
who will start your intravenous (iv) access
and administer any medications before
your procedure.
Before your procedure you will be asked to
sign consent forms to allow your doctors
to perform the procedure and, if needed, a
blood transfusion.
While your physician and the operating
or procedure room staff prepare for your
procedure, there will be a waiting period. if
you have any questions or concerns during
this time, please contact any of the pcu
staff or ask to speak to our administrator
of patient and family satisfaction. they will
be happy to assist you.
two or three family members or friends
may stay with you at the discretion of
staff until it is time for your procedure.
tvs are provided in each area for your
comfort.
Tower
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See page 16 and 17
for entire 4th floor and
Rush campus maps.

WhaT TO ExPECT aFTEr YOur PrOCEdurE
WhErE YOu Will gO aFTEr PrOCEdurE
After your procedure, you will recover in the recovery room or in an intensive
care unit, as appropriate for your procedure. during your recovery, the staff will
closely monitor your heart rate, breathing and blood pressure until you are ready
to be discharged home or moved to an inpatient room.
WhEN YOu WakE uP
You may be uncomfortable after your procedure. tell your doctor or nurse if you
have any of the following:
• nausea
• dizziness
• pain
• sore throat
these are common aftereffects of anesthesia and having a procedure. Your
doctor may prescribe medication to relieve these discomforts.
You may wake up with a small tube (or catheter) in your bladder. the catheter
helps you urinate and helps your doctor know that your kidneys and bladder are
working normally. A staff member can easily remove this tube when your doctor
says you are ready.
ViSiTaTiON aFTEr YOur PrOCEdurE
Outpatients: if you are having an outpatient procedure, visitation is permitted
once you are awake and able to move to a recliner, typically after 1 hour.
Inpatients: if you are staying in the hospital for a longer period of time, your
family may visit once you are transferred to your room, typically within 2 hours.
if you are still in the recovery area after 2 hours, your family may be permitted
to visit. visitation in the recovery area is limited to 2 people. if you have a large
family, please designate which 2 family members will visit.
BEgiN TO ParTiCiPaTE iN YOur rECOVErY
recovery goes more smoothly if you become physically active soon after your
procedure. for this reason, the staff will ask you to move and walk around as
soon as it is appropriate. You should gradually increase your activity level while
giving yourself time to rest.
You may be asked to complete deep breathing and coughing exercises to help
prevent fluids from building up in your lungs, a condition that can lead to
pneumonia. to help you get better faster, staff members may frequently ask
you to breathe deeply and cough.
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8
gOiNg hOME
Your doctor will decide when you are ready to be discharged from the hospital.
You will receive instructions on continuing your recovery at home.
CarE FOr YOur iNCiSiON Or PuNCTurE SiTE
An incision or puncture site may be closed with staples or stitches. Your incision
or puncture site may be covered by a bandage or dressing. there also may be a
tube in the incision and dressing.
the following are tips to help your incision heal quickly:
• Keep the area clean and dry.
• Wash your hands before and after touching the area.
• take warm showers instead of baths (if permitted in your doctor’s
instructions).
aSk QuESTiONS
Before you leave, you should ask the following
questions:
• What medicine(s) will i be taking at home? how
much medicine should i take? When should i
take it?
• What is the best way to care for my incision(s)?
• What signs of infection should i watch for?
• What should i eat?
• how should i bathe, and how often?
• When should i schedule my follow-up visit?
• how much physical activity can i handle?
• When can i resume sexual activity?
• can i drive?
• When can i go back to work?
Be sure that you and your family understand
all the instructions given to you. if you have
questions when you get home, call your doctor.
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When to Call Your Doctor
You should contact your
doctor if any of the
following occur:
• You develop a fever
higher than 101 degrees
Fahrenheit.
• You experience unusual
redness or drainage around
the incision or puncture site.
• You develop a rash around
the incision or puncture site.
• Your incision or puncture
site bleeds or you have
an open incision. Apply
pressure to affected area
to control bleeding; place
a bandage, if needed.
• Your medicine is not
controlling your pain.

PrEPariNg YOur Child FOr a PrOCEdurE
TalkiNg TO YOur Child aBOuT a PrOCEdurE
A procedure can be a stressful event at any age, but it can be especially
frightening and overwhelming for a child. We encourage families to tell their
children why they are going to the hospital, and what will happen during their
hospital stay. providing your child with this information is very important because
children who are well prepared for their hospital experience cope better and
recover more quickly than those who have not been prepared.
We understand that preparing a child for a procedure can be difficult for
parents. Along with feeling concern for your child’s health, it is common to
worry about how you will talk with your child about the upcoming event. here
are some helpful tips:
• Wait until just a day or two before the procedure to tell very young children
about going to the hospital.
• explain why the procedure is needed. reassure your child that they did nothing
wrong to cause this. Young children often think going to the hospital is a punishment
for something they did wrong.
• Give simple, honest explanations about what will happen before, during and
after a procedure.
• stress that he or she will be asleep when the procedure takes place. it is usually
best not to give a detailed explanation of the procedure or repair that takes place
after the child is asleep. for example, simply stating, “the doctor will fix your leg”
or “the doctor will take out your tonsils” is often all that is necessary.
• use nonthreatening words, such as “make a small opening” instead of “cut,” or
“feel a small pinch” instead of “hurt.”
• let your child know that you will not be able to be in the procedure room with
him or her during the procedure, but that he or she will be well cared for by the
doctors and nurses. emphasize that you will be nearby and reunited soon after
the procedure.
• mention possible discomfort your child may feel after the procedure.
• encourage your child to ask questions.
• use educational materials, such as “doctor toys,” dolls and books about the
hospital to give your child an opportunity to play or talk out his or her feelings.
• Allow your child the opportunity to make some choices, such as what toy to
bring to the hospital or what he or she would like to wear that day. this can
really make a difference! children feel better when they have some control over
what is happening.
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PrEPariNg YOur Child FOr a PrOCEdurE
Rush’s Special Program to Prepare Children for a Procedure
rush offers a special program to help you and your child prepare for a
procedure. this free program is held weekly and is designed for parents and
future pediatric patients. the program includes a tour of the procedure room
areas, admitting and pediatric unit. in addition to seeing areas they will be
visiting, the program gives children the opportunity to see and handle some
of the medical equipment doctors and nurses will use to care for them.
please call rush’s child life services at (312) 942-7842 to register for the
tour or speak to someone about preparing your child for a procedure.
The Virtual Tour
Because we know that many busy families are unable to bring their child to
the hospital for a live tour, rush has created an interactive virtual tour of the
operating room areas and pediatric unit. the virtual tour is in cd format and is
provided to you at no charge. Watching the tour will help you and your child
become more familiar with the hospital itself and learn about some of the things
that will happen the day of procedure. You can obtain one by calling child life
services at (312) 942-7842.
Make Child Care Arrangements for Your Other Children
please make child care arrangements for your other children. if your child is
having an outpatient procedure, plan on the child recovering in the procedural
area for approximately 1 to 3 hours after the procedure is over.
About Medications
sedation medications are used (as necessary) to reduce anxiety in the child
before going to the procedure room. the medications are administered as
painlessly as possible. oral medications are used instead of injections, when
possible. You will have the opportunity to discuss pre-operative sedation with
your anesthesiologist before the procedure.
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PrEPariNg YOur Child FOr a PrOCEdurE
Where to Wait During Your Child’s Procedure
While your child is in procedure, you can wait in the smith family lounge on
the floor where child’s procedure is taking place. please proceed to the smith
family lounge after your child goes into the procedure room, check in with the
volunteer and get a pager so you may be reached as soon as the procedure is
complete. You will be called to be with your child soon after he or she awakens
from the anesthesia.
Visiting and Spending the Night With Your Child
for children who stay in the hospital after a procedure, visiting hours are from
11 a.m. to 8 p.m. parents may visit at any time; however, only one parent
may sleep at the bedside. healthy siblings are permitted to visit during regular
visiting hours.
Elective Procedures
if your child becomes ill prior to an elective procedure, the procedure may need
to be canceled. please call your physician’s office if the child experiences fever,
cough, runny nose or other symptoms of illness the week before the procedure.
Remember to Follow Doctor’s Orders About Drinking and Eating
You will receive a call from the hospital the day before your child’s procedure to
confirm the time of the procedure and inform you of the time to stop feeding
your child. follow the feeding instructions exactly, because the procedure may
be canceled if the child has had something to eat or drink close to the time of
the procedure.
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12
addiTiONal iNFOrMaTiON
iMPOrTaNT dOCuMENTS
every procedure involves risk. Below are two kinds of documents that are
commonly completed by patients before a procedure.
General Informed Consent
A form is signed prior to the procedure, after a discussion of the risks and
benefits of the procedure with the doctor. this form grants permission to proceed
with your procedure.
Advance Directives
formal documents, written before you get seriously ill, state your choices
for health care, or identify the person to make those choices if you are unable
to do so.
aNESThESia
Anesthesia is medication to prevent pain during a procedure. Before your
procedure, a member of the anesthesia team will take your medical history and
examine you to determine what kind of anesthesia to use based on your health
and the type of procedure you are having. he or she will also talk about the risks
and benefits of the anesthesia plan, as well as the alternatives.
on the day of the procedure, a member of the anesthesia team will insert an iv
tube in your arm or hand vein to administer medications. in the procedure room,
the anesthesia staff will monitor your heart rate, blood pressure, breathing and
blood-oxygen level.
there are three types of anesthesia: general, regional and local (with or without
sedation).
General Anesthesia
General anesthesia means your entire body is “asleep” for the procedure. this
usually occurs in two stages. first, you will receive a drug through your iv tube
that will make you drift off to sleep and become unaware of what is going on
around you. the second stage of general anesthesia keeps you asleep through
your procedure. You may breathe anesthesia medication through a mask or
breathing tube, or receive it through your iv tube.
Regional Anesthesia
regional anesthesia numbs certain areas of the body so that you do not feel pain.
common types of regional anesthesia are epidural, spinal and caudal anesthesia.
All of these can numb large areas of your body from your abdomen down to
your feet. Another option is called a peripheral nerve block, which numbs smaller
areas of your body. With regional anesthesia, you may receive other drugs that
will make you drowsy or keep you in a light sleep.
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additional inforMation
Local Anesthesia
For some procedures, anesthetic drugs can be injected right around the area
of the procedure to numb the area locally. You may be awake and aware
during your procedure, or a member of the anesthesia team may give you
medicine that makes you drowsy or puts you in a light sleep. Whichever type of
anesthesia you have, the procedure room or anesthesia staff will closely monitor
your vital signs throughout the procedure.
Sedation
Sedation involves the use of pain relievers and sedative drugs to reduce or
minimize discomfort during procedures. Patients can receive medications that
will permit them to speak and respond to their health care providers during a
procedure. Sedation can also be provided to make you very drowsy or keep you
in a light sleep. Sedation is commonly used in combination with local anesthesia
and with regional anesthesia. It may also be used alone for noninvasive
procedures.
Controlling Pain after a ProCedure
As you recover, your doctor will order an appropriate medication for you based
on your condition. The nursing staff will assess your pain medication needs
throughout your stay.
Two common methods of controlling pain are epidural analgesia (or other forms
of nerve blocks) and intravenous patient-controlled analgesia pumps.
Epidural Analgesia/Regional Nerve Blocks
Epidural analgesia is a common method of pain control for patients who have
undergone a total joint replacement, a Cesarean delivery or another procedure on
the abdomen or chest.
A small plastic tube is placed in your back before procedure that delivers pain
medicine continuously right to the nerves that “create” pain. The staff can
control the amount of pain medication with a special pump during and after your
procedure.
Regional nerve block techniques can also be used in a similar manner to control pain
after procedures involving the arms or legs.
Intravenous Patient-Controlled Analgesia (PCA) Pumps
A PCA pump delivers a prescribed amount of pain medication into your arm vein
through an IV tube. You can control the amount of pain medication that flows into
your blood by pressing a button on a hand-held device attached to the pump. The
pump is programmed so that it will not deliver too much pain medication.
IMPORTANT: Only the patient should use the PCA button.
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gETTiNg TO ruSh
rush university medical center is located just off the eisenhower expressway
(i-290), five minutes west of chicago’s loop. it is easily accessible by car and
public transportation.
By Car
From the north:
• take the Kennedy expressway (i-90/94) to the eisenhower expressway (i-290).
• drive west on the eisenhower to the Ashland-paulina exit.
• turn south (left) on Ashland Avenue to harrison street.
• turn west (right) to rush.
From the west:
• take the eisenhower expressway (i-290) to the Ashland-paulina exit.
• drive straight one block to Ashland Avenue.
• turn south (right) to harrison street.
• turn west (right) to rush.
From the southwest:
• take the stevenson expressway (i-55) to the Ashland exit.
• drive north (left) on Ashland Avenue to harrison street.
• turn west (left) to rush.
From downtown Chicago:
• drive west on congress parkway, which becomes the eisenhower expressway
(i-290).
• take the Ashland-paulina exit.
• turn south (left) on Ashland Avenue to harrison street.
• turn west (right) to rush.
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gETTiNg TO ruSh
Parking
the maps on pages 16 and 17 indicate where parking garages are located at
rush. the following discount garage parking options are available for patients
and visitors:
• A senior citizen’s discount is available for patients and visitors who show their
senior citizen or medicare cards when leaving the garage.
• discount parking coupon booklets are available and may be purchased at the
guest relations desks in the 4th floor Atrium Building lobby and the 4th floor
Armour Academic center entrance from the parking garage. discount coupons
are not valid for valet parking.
people with disabilities with proper identification receive a discounted rate for
valet parking. for people who need wheelchair transport, assistance is available
at the valet parking entrances at the hospital’s main entrance (the Brennan
pavilion), the Johnston r. Bowman center and the professional Building (see
below for addresses and phone numbers). designated parking for people with
disabilities is available on the 4th and 5th floor levels of section A in the garage.
A valid disability license plate or placard must be visible.
valet parking is available at the hospital’s main entrance, 1620 W. harrison st.,
(312) 942-7442; the Bowman center, 710 s. paulina st., (312) 942-7000; and the
professional Building,1725 W. harrison st., (312) 942-3720. discount coupons are
not valid at the valet parking sites.
By Public Transportation
• “el” trains: rush is served by the Blue line (at the illinois medical district stop)
and the pink line (at the polk stop).
• Bus routes: the primary bus routes to rush are the 7 harrison bus (weekdays)
and the 126 Jackson bus (weekends).
• times and routes for public transportation may be obtained by calling the
regional transportation Authority (rtA) at (312) 836-7000.
• the valet parking and information desk staff in the hospital’s main entrance can
call a taxi for you.
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16
GETTING TO RUSH
campUS map
NORTH
KEY
Hospital
parking
W H A T Y O U N E E D T O K N O W A B O U T H A V I N G A P R O C E D U R E
cab Stand
Emergency Valet
Bike Rack
cTa Train

GETTING AROUND RUSH
FOURTH FlOOR MAp
KEY
Emergency public Elevators Restrooms
Restaurant
ATM
Vending
Hospital
parking
Information
Valet
Registration
lounge
Coffee Shop
Gift Shop
pharmacy
Chapel
NORTH
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P-2651 12/11
We hope this booklet has been helpful.
By keeping you informed, we hope to lessen your anxiety
and encourage your participation in your care.
produced by the rush patient education planning and development oversight committee
in conjunction with a multidisciplinary team of health care professionals, which includes
physicians, nurses and allied health professionals.
The information contained in this brochure is believed to be accurate; however, any questions about your individual
health concerns or treatments should be referred to your physician.
rush is a not-for-profit health care, education and research
enterprise comprising rush university medical center,
rush university, rush oak park hospital and rush health.