Texas Children's Cancer and Hematology Center

Post Anesthesia Care Unit (PACU)

The Post Anesthesia Care Unit (PACU) sees patients who are scheduled for a procedure under sedation or anesthesia. Procedures done in PACU include bone marrow aspirates, bone marrow biopsies, and spinal taps [also called lumbar punctures] with or without chemotherapy. Your child may be scheduled for one or more of these procedures. The PACU area is located on the 7th floor of the Mark Wallace Tower.

The goal of the PACU team is to provide the best care for your child and to keep you informed of your child’s progress. This information sheet will help you understand what will take place before, during and after your child’s procedure. The PACU schedule begins at 10am on Mon, Tues, Wed, and Friday, and at 12pm on Thurs, and continues until all procedures are completed. Some patients need more than one procedure under sedation / anesthesia, so wait times can sometimes take longer than expected. We know that waiting for your child to have a procedure can be stressful. We will work to keep you informed of any changes or delays in your child’s estimated procedure time. Providing the least stressful and best possible care for your child is our priority!

What to expect on the day of your child's procedure

Your child will check in the Hematology/Oncology or Bone Marrow Transplant Clinic early in the morning at a set appointment time. Blood tests and a physical exam will be done in the clinic. Blood counts will be checked to be sure your child is ready for the procedure. If your child needs a blood or platelet transfusion, this will be given to reduce risks from the sedation or the procedure. If your child is going to get a spinal tap with chemotherapy, the medicine will be ordered and sent directly to the PACU so it will be ready when your child arrives. After your child’s exam in the clinic, you will take your child to the PACU OR receptionist desk, and check in for the PACU procedure.

On the morning of the procedure, your child will need to be ‘NPO”. NPO is Latin for “nil per os.” In English, that means nothing by mouth. Your child should not have solid food, hard candy or gum for 6 hours prior to anesthesia, but can have clear liquids up to 2 hours before the procedure. We understand that being NPO can be hard for both children and families. At Texas Children’s, caring for your child as safely and as quickly as possible is important to us.

Before going to the PACU, the clinic team will start fluids through an IV [intravenous] line. Although your child may not like being NPO, he or she will feel better receiving fluids through the IV. We care about your child’s comfort. You are welcome to bring toys, games, videos or music to help your child pass the time while in the waiting area. PACU Child Life Specialists are available to help you support your child in the PACU. Speak with a receptionist on check-in or with the PACU nurse to ask for a Child Life Specialist.

Upon arrival to the PACU, you will meet with the anesthesia team. The team includes the nurse practitioner and anesthesiologist. Nurse practitioners are registered nurses who have advanced education and training. Anesthesiologists are doctors who give medicines, or anesthesia, so your child doesn’t feel anything during surgeries or procedures.

Before the procedure, the PACU team will review your child’s health history, lab results, chemotherapy treatment plan, and ask you important questions about your child’s health. The team will also obtain consent for the sedation / anesthesia. We encourage you to ask questions and discuss any concerns you have with the team. The anesthesiologists will provide sedation or anesthesia for your child to have his or her procedure. With sedation, medicine is used to help patients feel relaxed and comfortable during the procedures. With anesthesia, medicine is used to help patients fall asleep, preventing them from feeling any pain. The anesthesiologists will provide what your child needs to have his or her procedure without pain.

When it is time, your child will be taken to the procedure room. The PACU team will ask you if you understand the procedure your child will have performed and double check their identification bracelet. You may remain with your child until he or she falls asleep. You may wait for your child in the nearby waiting area during the procedure. Most procedures take 20-30 minutes. More time is needed when more than one procedure is done.

After the procedure, your child will be moved to the PACU recovery area where he or she will be closely monitored until he or she is awake and ready to leave. The PACU nurse will call you to join your child in the PACU recovery area. Your child’s doctor will decide if your child will be discharged to home, go back to the clinic, or be admitted to the hospital for treatment.

If you have any questions or concerns about your child’s procedure or stay in the PACU, please ask to speak to a member of the PACU team – we are all here to help.

If you valet park on the day of your child’s PACU procedure, the PACU will validate your parking.