Paediatrics - Your child's day case Grommet Procedure

Walk In Walk Out (WIWO) Unit

Please arrive on the Children’s Unit at 07:30 AM to be met by the surgical team and escorted up to WIWO (Walk in Walk Out) theatre unit.

Once upstairs, you/your child will be asked questions regarding their health and fasting status. We will obtain your child’s weight and observations (heart rate, blood pressure, temperature, respiratory rate) to ensure they are fit for surgery on the day. If your child has no allergies to the “magic cream” (numbing cream), this will be applied to the back of their hands and occasionally the inner elbow area too.

Thereafter, they will be seen by anaesthetists and surgeons who will ask similar questions like the ones asked on admission, all to ensure safety. Once you have been seen by the surgeons/ anaesthetists and consent form has been signed, there may be a small wait until your child goes to theatre. You will be able to accompany your child into the anaesthetic room. Once your child is asleep, you can wait in the waiting area or go off the department to get some fresh air/food.

The operating procedure can take between 30-40 minutes including anaesthetic and recovery times which can differ patient to patient which we will advise you of on the day.

What are grommets and why do I need grommet insertion?

Grommets are small plastic tubes that sit in the ear which help to keep the ear clean (Robb et al, 2022). Your child may require grommets due to a condition called “glue ear” which is a term to describe the fluid that builds up behind the eardrum (Robb et al, 2022). Occasionally this build-up of fluid can cause infections which grommets may help to resolve.

What happens on the day of surgery?

Ear, Nose and Throat surgery is carried out on our paediatric day case unit in the Walk In Walk Out (WIWO) Unit. This is a self- contained unit where admission, anaesthesia, surgery, recovery and discharge are carried out in the one area.
You will be asked to arrive on the unit at 07.30 am, where you will meet the nursing team who will be looking after you during your stay.

When to next give your child pain relief

Your child can next have Paracetamol at:     (6 hourly thereafter)
Your child can next have Ibuprofen at:     (8 hourly thereafter)

Grommet’s aftercare

Your child will remain on the WIWO unit for approximately 2 hours following their surgery. This is to ensure that the general anaesthetic they have received is wearing off, that they can eat and drink okay, are not vomiting, able to pass urine and are pain free.

Pain relief – Your child will be given pain relief in theatre and may receive some more if they are in pain following surgery. You will be informed prior to discharge when they can next have some more. It is important that your child receives paracetamol/ ibuprofen regularly for the first day and then as and when required after day 1.

Time off school – Your child will require 2 days off school to recover from surgery to ensure the general anaesthetic they have received has worn off. A letter will be given to you upon discharge.

Follow-up appointment - On occasion following your child’s grommets procedure, they may need to come back to an ENT clinic for assessment and/or a hearing test. You will be informed of this prior to discharge.

Further reading

ENT UK provide fantastic advice for any questions you may have prior to surgery and any tips for aftercare. Some of these links are:
https://www.entuk.org/patients/conditions/5/grommets/

https://www.entuk.org/patients/conditions/4/glue_ear_ome

If you are worried about your child and need any advice please ring 0161 627 8866.