Booking and determination of a surgical date

• Once the surgical consent form and additional documents (if required) have been signed they will be forwarded on to the hospital booking office.

• The hospital booking office will contact you with a proposed date and time for surgery (this may take weeks to months); the Comox Valley Orthopaedics office DOES NOT determine the surgical date.

Planning and considerations before surgery

• Staff from the booking office or pre-admission clinic will contact you about a week before your surgical date to inform you if blood tests, an ECG, or more X-rays are required.

• You may be contacted by an anesthesiologist to discuss perioperative issues and determine the risks of surgery, usually related to other medical conditions you may have ie. asthma, COPD, heart conditions, etc.

• You will be advised when to fast before surgery ie. NOTHING to eat or drink from midnight (12:00AM) the night before surgery, but this will differ depending on what time your surgery is.

• You will be advised which medications you should stop or continue leading up to your surgery, and how many days before surgery to do so. This is particularly important for:

  • blood thinners or anticoagulant medications

  • diabetes medications ie. oral hypoglycemics, insulin

  • heart medications ie. rate control, antihypertensives

• Stopping smoking before surgery is very important for any procedure to decrease your risk of complications. It is especially important for total joint replacement, or foot and ankle surgery. You likely will have discussed this with your surgeon beforehand, but you should stop at least 6 weeks prior to surgery, and not restart for at least 6 weeks after surgery. Many resources exist to help you quit, including your family physician.

The morning of surgery

• Thoroughly shower and clean the surgical limb or area the morning of surgery.

• Bring with you any crutches, gait aids, braces, slings, or post-op shoes you may already have to be used after surgery.

• Arrive at the North Island Hospital Comox Valley (Comox Valley Hospital) located at 101 Lerwick Road in Courtenay, British Columbia approximately 2 hours before your surgery.

• Present yourself to the Patient Registration/Admitting desk on the 1st floor. They will check you in to the hospital and send you to the Surgical Registration desk on the 2nd floor.

2 hours before surgery

• Check in at the Surgical Registration desk on the 2nd floor.

• You will then be taken over to the Surgical Daycare area.

1.5 hours before surgery

• You will be taken over to the Pre-Operative area and meet your nurse. You will be assigned a bay with your own bed.

• You will be directed to change out of your clothes into a surgical gown, booties, and hair covering.

• They will check you in, ask questions, and review all relevant documentation with you, including the surgical consent.

• You may have an IV started at this time.

30-60 minutes before surgery

• A nurse from the operating room will come to meet you and ask further questions, reviewing the previous documentation once again, including the surgical consent.

• You will meet your anesthesiologist and decide what type of anesthesia you will have for your surgery ie. general anesthetic, spinal anesthetic, or local block (freezing of the limb or surgical area).

• You will meet your surgeon and review the consent, confirm the side and site of surgery, and answer any questions related to the procedure that you may still have. The limb or joint will be marked with a marker to confirm the surgical site.

5-10 minutes before surgery

• You will be taken to the Operating Room by the nurse, care aide, or anesthesia assistant.

• An operative time-out/surgical pause will take place to confirm all relevant surgical and safety details.

• The anesthesia will commence, followed shortly by the surgical procedure itself.