Paediatrics - Your child's day case Tonsillectomy procedure

Walk In Walk Out (WIWO) Unit

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.

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 60-90 minutes including anaesthetic and recovery times which can differ patient to patient which we will advise you of on the day.

What are tonsils and why do I need a tonsillectomy?

Tonsils are two small glands that sit at the back of your throat that help to fight infections (Robb et al 2022). Your child may be recommended to have a tonsillectomy because they have recurrent tonsillitis and/or sleep disturbances called sleep apnoea. Occasionally your child may require their ‘adenoids’ to be removed also, which are similar to tonsils, but these glands sit at the back of the nose (Douglas, 2022).

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)

Tonsillectomy aftercare

Your child will remain on the WIWO unit for approximately 4 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.

Diet – Your child can eat and drink most foods providing that the food is not hot in temperature or spice. Avoid red juices or citrussy drinks and foods that are too sharp. A common question asked is “can my child have ice cream.”. Yes, they can! If it is not in replacement of a meal, rather given as a comforter between meals.

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 at least 3-5 days following their tonsillectomy.

Time off school – Your child will require 2 weeks off school to recover from surgery (infection and bleeding risks). A letter will be given to you upon discharge.

Bleeding – Although rare, if your child has a bleed following their surgery this is classed as an emergency. Contact 999 for an ambulance who may need to bring your child back to an A&E department to be reviewed.

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

Further reading

ENT UK provide fantastic advice for any questions you may have prior to surgery and any tips for aftercare.
https://www.entuk.org/patients/conditions