Surgery Guide - RPTHRP
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On the Day of Surgery


You and the person accompanying you should come to Patient Access Services in the first floor lobby. When you arrive, the Patient Access Services/Admitting staff will process your admission, issue your identification bracelet and direct you to the 4th Floor Family Atrium.

The 4th Floor Family Atrium is a lounge area and central hub where our patients and family members meet and wait for information following surgery. It is equipped with comfortable chairs and offers amenities that include a coffee bar, food cart, television services and computer access. The area is equipped with Wi-Fi, and cell phone use is allowed.

Members of the Same Day Surgery (SDS) nursing staff will greet and escort you and the person accompanying you to the presurgical holding area. This is where you will meet a physician assistant (PA) who will reassess your condition and medical/surgical history. PAs are healthcare professionals licensed to practice medicine with physician supervision. As part of their comprehensive responsibilities, PAs conduct physical exams, diagnose and treat illnesses, order and review tests, counsel on preventive healthcare, assist in surgery, and prescribe medications. PAs work closely with other members of the operating room (OR) and anesthesia teams. They will finalize your presurgical preparations.

The SDS nursing staff will complete your admission process, check your identification band and assist you with changing into our hospital gown. Your belongings, which should fit in one small bag, will be labeled, and will remain with the security department until you are sent to an inpatient room. You should ask the person accompanying you to hold onto your eyeglasses and hearing aids for you, and to return them to you following surgery.

The SDS nursing staff will wash and prepare the surgical site area. They will also start an intravenous (IV) line. The IV provides a route for fluids, medications and blood products, if necessary. It is also the main route for your antibiotics to prevent and reduce the risk of infection. The IV bag and tubing will likely be disconnected after 24 hours when your medication is complete and you have tolerated fluids and food. We will keep the IV access secured until you are discharged. A PA and other members of your surgical team will take your latest information and perform some additional safety cross-checks and tasks. They will review the surgical consent with you and have you sign the actual consent paperwork. Your surgeon will confirm your identity, review and then sign your surgical site with a surgical marker. These steps are an important part of the process designed to ensure patient safety.

Members of your anesthesia team will review and explain the plan for anesthesia, including the type of anesthesia (epidural or spinal), your level of sedation and your postsurgical pain management. The anesthesiologist will also ask you to sign the consent to perform anesthesia. A majority of our TJR patients will receive IV sedation and a combined spinal or epidural anesthetic, in which a narrow catheter (tube) is inserted in the lower spine and allows a continuous flow of anesthetic medication to block all feeling during the surgery. The level of sedation and anesthesia is tailored to your specific needs and will allow you to awaken very soon after the surgical procedure is completed.

Members of the OR staff will recheck that all of the appropriate paperwork and tasks have been performed. They will then escort you on a stretcher into one of the operating room suites. The person accompanying you will be instructed to return to the Family Atrium.

TJR surgery generally takes approximately 1 to 1½ hours, but the actual elapsed time from operating room to post-anesthesia care unit is usually about 2½ hours. Your surgeon will provide more specific details and will make arrangements to meet with your family in the Family Atrium following surgery, or will make other arrangements to contact them. Please provide the surgeon with specific contact information as to where and how your family can be reached.

The Family Resource Line (212.774.7547) can be utilized if you would like furtherinformation on what to expect the day of surgery. Please encourage your visitors to call if they have any questions.