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Children's Hospital of Pittsburgh
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Children's Hospital of Pittsburgh

Parental Presence at Induction of Anesthesia

Parental Presence at Induction of AnesthesiaWhat is parental presence at induction of anesthesia? This is when a parent accompanies their child into the operating room until their child falls asleep with anesthesia medications. You might be invited to participate in the induction phase of your child’s anesthesia at the discretion of the anesthesiologist based on various factors and circumstances. Please read the following information to learn about this policy, how it applies to your child’s visit and how you can help.

Fast Facts About the Parental Presence At Induction Policy

  • This policy was created to reduce the anxiety levels of children who are having anesthesia for a test, surgery or other medical procedure.
  • Certain circumstances do not allow for a parent to be present at the induction of anesthesia. The final decision about whether a parent may accompany a child into the operating will be made by your child’s anesthesiologist.
  • Some circumstances that preclude parental presence are as follows:
    • Child is having emergency surgery.
    • Child is less than one year in age.
    • Parent is pregnant.
  • A parent who accompanies a child as anesthesia is given must follow the instructions of the medical staff at all times.
  • Only one parent or guardian may accompany your child into the operating room. Other parents and family members must stay in the waiting room.
  • If the child’s condition changes or the parent’s presence is in any way distracting or disruptive to the induction of anesthesia, the anesthesiologist or medical staff have the right to ask the parent to leave the operating room.

Once your child has been registered for the procedure, a nurse will meet with you and your child to take your child’s vital signs, weight and medical history. As the parent or legal guardian, you will be asked to sign a consent form before the sedation medication is given.

  • Your child’s doctor will decide which type of medication is right for your child, depending on your child’s age, medical history and the type of surgery or test being done. Medication can be given through a mask or directly into a vein through an intravenous (IV) line.
  • If it has been determined by the anesthesiologist that parental presence will contribute to the success of your child’s visit, before entering the operating room, you will be asked to put on a disposable jumpsuit and hair cover to keep the room sterile. This one-size-fits-all, zippered jumpsuit—often called a “bunny suit”—will fit over your street clothes and can be taken off and thrown away after you leave the operating room.
  • You may stay with your child until he or she is asleep. You will be taken to the waiting room when the procedure, surgery or test is ready to begin.

Anesthesia (an-ess-THEEZ-ya) medication can be given either in a liquid form through an intravenous (IV) line directly into a vein or in a gas form by breathing through a mask. If your child is very upset, the doctor can give a relaxation medication by mouth before the induction. This medication is flavored and takes effect in 10 to 15 minutes.

  • Anesthesia Medication Through IV

    Older children or children who are not afraid of needles may choose to have IV anesthesia.  The IV form of anesthesia requires a needle to be inserted into the child’s vein, usually in the hand or arm. When anesthesia medication is given through an IV catheter (or tube), the child falls asleep in seconds. 

  • Anesthesia Medication Through Mask

    Younger children usually will get their sleep medication through a “space mask” that will carry air mixed with medication. Your child may choose a favorite scent to flavor the air flowing through the mask. When the medication is given through a mask, there are no needles or shots used while your child is still awake.
    • When going to sleep with a mask, children frequently try to take off the mask and/or become combative as they go to sleep. This is a normal reaction.
    • Children often will cough, gag, cry, complain about the smell or say they cannot breathe. These reactions are common responses to placing a mask over a child’s mouth and nose.
    • When children are given anesthesia through a mask, it generally takes 60 to 90 seconds before the child is asleep. When the child falls asleep, he or she will become limp and nonresponsive.
    • Once your child is asleep, an IV will be started so that medication can be given to keep him or her sleeping throughout the procedure.

When your child has fallen asleep, you will be taken to the waiting room.

As a parent, watching your child undergo anesthesia may be a very uncomfortable experience for you. Children can sense a parent’s concern—so for your presence to be helpful to your child, you must try to be as calm and encouraging as possible.

There are ways you can help your child, even if you feel uncomfortable.

  • You can touch your child to remind your child that you are there. Holding your child’s hand or caressing his or her hair and face will remind your child of your presence.
  • You can whisper, talk or sing to your child. The sound of your voice can provide reassurance.
General Anesthesia with Caudal Anesthesia
  • Even with a parent present, the operating room can be a scary place for a child. Do not feel bad if your child gets upset—even with you there to help.
  • The main purpose of your presence at the induction of anesthesia is to help your child; therefore, your child’s safety is our primary concern. If you are asked to leave the room for any reason, you must do so quickly and quietly. The medical staff needs to focus their full attention on your child.
  • If you feel uncomfortable and are unable to stay in the room during induction, please tell one of the medical staff.  You will be guided to the waiting room.

If your child has any special needs or health issues you feel the doctor needs to know about, please call the Department of Pediatric Anesthesiology at 412-692-5260, before the procedure and ask to speak with an anesthesiologist. It is important to notify us in advance about any special needs your child might have.