Pre-admission appointment for cardiology

This page explains about the pre-admission appointment for cardiology held at Great Ormond Street Hospital and what to expect when you and your child attend one.The purpose of this visit to hospital is to make sure that your child is prepared for their planned procedure or operation. This avoids delays and reduces the risk of cancellation. The results of any tests or investigations are available in plenty of time and can also be re-checked if they are not within the expected range
The appointment is a useful opportunity for you and your child to visit the wards, meet the team, discuss the planned procedure and ask any questions,

In most cases, the pre-admission appointment is arranged a few weeks in advance of your child’s admission date but occasionally, it happens on the day before admission. If the pre-admission appointment is on the day before admission and you live outside the London area, we will arrange for you to stay overnight in the Patient Hotel. Please leave any luggage in the Patient Hotel storage area before you come to Walrus Ward
Your child will have various tests and investigations during the pre-admission visit as part of an individualised package for your child’s planned procedure. This will include some or all of the following:

• Echocardiogram (ECHO)
• Electrocardiogram (ECG)
• Chest x-ray
• Blood samples
• Physical examination
• Clinical history
• Psychological assessment and preparation
• Baseline observations
• Nose and throat swabs

It will be a busy day so we would prefer you to arrange child care for your other children to avoid bringing them to the appointment as well. If this is difficult, please telephone us beforehand to discuss.

• Child health record (red book)
• Your current contact details including mobile phone number
• Contact details for your family doctor (GP) and any other health professionals involved in your child’s care
• A list of the medications your child is taking
• Any other information that will help us to plan your child’s stay with us
• Food and drink for you and your child plus nappies and feeds if applicable

When the pre-admission appointment has finished, you and your child can go home. We hope your child will have the operation, test or procedure within the next three months. If we have a cancellation, we may ring you to see if you and your child can come to the hospital at short notice, if this is convenient

You will be informed the night before the procedure of the time that your child should be ‘nil by mouth’ – in other words, have nothing to eat or drink before the anaesthetic. It is equally important to keep giving your child food and drink until those times to ensure they remain well-hydrated and get adequate nutrition. This may
involve waking your child in the night to give them a drink which we recommend

Depending on the planned procedure, we may ask you to stop giving your child their regular medications for a certain period before admission. We will discuss this with you during the pre-admission appointment.

Some illnesses increase the usual risks of anaesthesia so we may feel it is safer to postpone your child’s procedure until they are well. The majority of planned procedures are non-urgent, so they can be safely postponed. However, there will be some procedures where the benefits of going ahead outweigh the risks of postponing. The team need to have a full picture of your child’s health before making the decision to continue
with the planned procedure or to postpone it If you have any questions about whether your child is fit and well enough for the procedure and general anaesthetic, please telephone us as soon as possible.

We will usually postpone a planned procedure if your child:

• Has a high temperature
• Has a streaming nose
• Has a wheezy cough
• Is listless and off their food
• Is receiving treatment for the cough or cold from your family doctor (GP) or pharmacist

• Is generally well
• Is eating and drinking as usual

We will usually postpone a planned procedure if your child:

• Has a chest infection confirmed by a health professional

• Has regular chest infections as part of their medical condition

Chicken pox is infectious from two days before the appearance of the spots until all of the spots have dried up completely. The chicken pox virus is spread through the air, which means that your child can catch chicken pox by being in the same room as someone with chicken pox or who develops it within the next two days. Shingles are infectious from when the rash appears until it has completely crusted over.

We will usually postpone a planned procedure if your child:

• Has chicken pox or shingles
• If your child has not already had chickenpox or the chickenpox vaccination and has been in contact with someone with chickenpox or shingles within the last three weeks

Diarrhoea and/or vomiting are usually caused by a stomach bug, which is extremely infectious while symptoms are present. It can take up to two days for symptoms to develop after coming into contact with someone with a stomach bug,

We will usually postpone a planned procedure if your child:

• Has had diarrhoea and/or vomiting in the two days leading up to the planned procedure
• Has been in contact with someone with diarrhoea and/or vomiting in the two days leading up to the planned procedure

• Has these symptoms as a result of their medical condition

We will usually postpone a planned procedure if your child:

• Has coloured discharge (ooze) in the days leading up to the planned procedure 

• Has these symptoms as a result of their medical condition

Hand, foot and mouth disease causes blistering of the skin on the hands, feet and around the mouth. This blistering affects how the skin heals and how it protects against infection. A child with hand, foot and mouth disease is infectious for about seven days after the symptoms first occur. It can take between three and six days for the symptoms to appear after coming into contact with someone with hand, foot and mouth disease.

We will usually postpone a planned procedure if your child:

• Has hand, foot and mouth disease
• Has been in contact with someone with hand, foot and mouth disease in the week leading up to the planned procedure

Someone with measles is infectious from up to five days before the appearance of the rash until four days after the rash has appeared. The measles virus is spread through the air, which means that your child can catch measles by being in the same room as someone with measles or who develops the measles rash within the next five days.

We will usually postpone a planned procedure if your child:

• Has measles
• Has not already had measles or two doses of the MMR vaccine and has been in contact with someone with measles in the two weeks leading up to the planned
  procedure.

There are many childhood illnesses and we cannot include them all in this information sheet. As ageneral rule, the following applies:

We will usually postpone a planned procedure if your child:

• Is taking antibiotics for treatment rather than prevention unless they have been prescribed by a specialist team for treatment of the condition
• Has a high temperature
• Has a wheezy cough

• Is taking preventative low-dose antibiotics

If your child’s pre-admission clinic is more than seven days before operation day, you will need to come back to the hospital for further blood samples before the planned admission. This will be a short visit lasting around 30 minutes. If you live outside the London area, we will arrange for you to visit us the day before the operation and stay overnight in the Patient Hotel before admission the following morning.

If you have any questions, please telephone Walrus (Cardiac Day Care) on 020 7813 8347. Out of hours, please telephone Bear Ward on 020 7829 8829.