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St Jude NPO nothing by mouth


St. Jude

February 2011

               Travel safely after sedation or anesthesia
     ometimes your child will need to      in a car or a plane, you might not be     issues, talk to the doctor who gives
     stay very still or even go to sleep   able to get help right away.              anesthesia to find out when your
     during a procedure or surgery.           To keep your child safe, the           child can safely leave the St. Jude
To help your child relax and feel no       hospital asks you not to travel until     campus.
pain, the staff will give one of two       a certain amount of time has passed         There are stricter guidelines for
kinds of sleeping medicine. One is         after your child receives anesthesia or   infants, especially those born prema-
called anesthesia; the other is called a   a sedative.                               turely. The doctor or nurse will
sedative.                                  After a minor procedure                   discuss those with you.
   Sedatives and anesthesia can stay          There are many different minor
in your child’s system for 24 hours        procedures including an MRI, CT
or more. During this time, your child      scan, nuclear medicine scan, radia-
may:                                       tion therapy, some eye procedures,
 •	 Have problems breathing;               a lumbar puncture, a bone marrow
 •	 Not be able to function properly;      biopsy, a PICC line placement or          Housing is provided
    or                                     subcutaneous port removal.                  If you need to stay in town for the
 •	 Become distressed or upset.               Following a minor procedure, your      night because of the travel restric-
   When your child needs help, every       child can travel by car after discharge   tions mentioned above, St. Jude will
second counts. If any of these things      from the recovery area. However,          provide your family with housing.
happen while your child is traveling       before flying in an airplane your child   Like you, the St. Jude staff puts your
                                           must spend at least four hours on the     child’s safety first. If waiting a little
                                           St. Jude campus after being released      longer to leave Memphis means that
                                           from the recovery area.                   you and your child will return home
                                           After a major procedure/surgery           safely, it will be time well spent.
                                              Major procedures and surgeries           To learn more about anesthesia and
                                           involve a cut in the skin and other       sedation and the guidelines for travel,
                                           tissues. Examples include placing a       ask for a copy of the new handout
                                           central venous line or removing deep      “Do You Know… Travel after Seda-
                                           tissue organ samples.                     tion or Anesthesia.”
                                              After a major procedure or surgery,
                                           your child will be admitted to the
                                           hospital or will be required to stay in
                                           St. Jude housing or in the Memphis
                                                                                     Transplant Unit has
                                           area for the first night.                 stricter guidelines
                                           Special cases
                                              If your child has severe health        than other areas
                                           problems such as heart or breathing
                                                                                        In case you haven’t heard, visit-

NPO guidelines recently revised                                                      ing guidelines and infection control
                                                                                     policies for the Transplant Unit are
  If your child must be completely still for a surgery or procedure, the staff       much stricter than they are for other
will probably give sleeping medicine called anesthesia or sedation. Patients         St. Jude inpatient units and clinics.
who have full stomachs when taking anesthesia or sedation are at risk of             At certain times during the transplant
getting food or liquid in their lungs during the procedure. This could cause         process, these patients are at even
pneumonia or other serious health problems. For this reason, the hospital has a      greater risk for infection than pa-
policy that gives a timeline for when your child should stop eating and drink-       tients who have not had a transplant.
ing before a surgery or procedure. The policy is called NPO, which is short for      For the safety of all transplant pa-
the Latin words nil per os, meaning “nothing by mouth.”                              tients, please read “Do You Know…
  St. Jude has recently updated the NPO policy and the handouts that explain         Transplant Unit Guidelines” if your
this policy to patient families. The two handouts that explain this policy are       child is placed on the Transplant
called “Do You Know… NPO – No Food/Drink Before Surgery” and “Do                     Unit.
You Know… NPO – No Food/Drink Before Non-Surgical Procedures.”                          Outpatients should never visit
  To follow the correct NPO guidelines, it is important for you to know the          inpatient rooms, and patients should
kind of procedure your child will have – surgery, PET scan, another non-surgi-       enter the Transplant Unit only if they
cal test or procedure. You also need to know what kind of sleeping medicine          are assigned to that unit. If you have
your child will receive – general anesthesia, IV sedation or sedation by mouth.      questions about St. Jude visiting
  To learn more, ask your child’s nurse for a copy of the NPO Do You Know            policies, please talk to your child’s
handout when your child is going to have anesthesia or sedation.                     doctor or nurse.
                                     Second floor construction update
                                       For several months in 2010, the         construction began the first week in
                                     St. Jude staff looked at the safety and   November.
                                     efficiency of the areas used for pre-       For this construction to be possible,
                                     paring medicines on the Patient Care      all patients on these units had to be
                                     Center (PCC) second floor. These          moved. During the past few weeks,
                                     areas are part of the Leukemia/           the Leukemia/Hematology Unit
                                     Hematology Unit and the Solid             (normally 2 North) has been on the
                                     Tumor/Neuro-Oncology Unit. The            Patient Care Center fourth floor, and
                                     staff had three main goals in their       the Solid Tumor/Neuro-Oncology
                                     review:                                   Unit has been located on the north
                                     •	 To ensure patient safety by creat-     end of the second floor.
                                         ing areas for nurses to prepare         All construction should be com-
                                         medicines that are as free from       plete by February 23. At that time,
                                         distractions as possible              the Solid Tumor/Neuro-Oncology
                                     •	 To make sure that St. Jude follows     Unit will return to 2 South and the
                                         all regulatory agency rules           Leukemia/Hematology Unit will
                                     •	 To improve the overall workflow        return to 2 North.
                                         on the units                            The staff thanks all patient families
                                       One result of this review was a plan    in advance for their patience and
                                     to build a medicine preparation room      understanding during this time. If you
                                     on each “pod” of the second floor.        have concerns during these moves
                                     That means two medicine prep rooms        or during construction, please talk to
                                     per unit.                                 the inpatient coordinator, manager or
                                       This plan was approved, and             director.

                                          Medication Station

                                         J-Tip reduces needlestick pain fast
                                          Some treatments, such as starting an IV or putting a needle in a port,
                                        are painful. Whenever possible, your child should have the option of
                                        reducing this pain as much as possible. One way to feel less pain from
                                        needles is to numb the skin before a needle is put into the skin.
                                          At St. Jude, the staff can use a medicine called lidocaine to numb
                                        your child’s skin. Lidocaine has been available in a cream (L·M·X4™)
                                        for many years, but it can take more than 30 minutes to numb the skin.
                                        Now there is a new way to give lidocaine within one minute. It is called
                                        the J-Tip®. The J-Tip® is a needle-free device that uses high-pressure
                                        gas to push the medicine (lidocaine) into the top layer of skin. Your
                                        child needs to know that the J-Tip® makes a loud “hissing” or “popping”
                                        noise like opening a soda can. Both lidocaine cream and the J- Tip® will
                                        numb the skin for about 90 minutes.
                                          Lidocaine cream and the J-Tip® cannot be used by anyone who is al-
                                        lergic to lidocaine (xylocaine) or other local anesthetics (pain relievers).
                                          To learn more about the J-Tip® and numbing the skin with lidocaine,
                                        ask for a copy of the handout “Using Lidocaine to Reduce Needlestick

                                                                               St. Jude Parents is published on the first of
                                                                               each month by Patient Education and Bio-
                                                                               medical Communications. Your questions and
                                                                               comments are important to us. We want to
                                                                               print advice and tips from St. Jude parents
                                                                               to other St. Jude parents. To share your
                                                                               ideas or to receive this newsletter by e-mail,
For the latest details on upcoming                                             please call or e-mail Alicia Huettel, RN,
events, see the bulletin board in                                              MSN, at 901-595-5453 (parents_newsletter@
                                                                      or Lois Young (loislane.young@
the Patient Care Center lobby near
Patient Registration.                                                          St. Jude is an Equal Opportunity Employer.

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