Sheffield Children's NHS Foundation Trust

Dr Judith Short, Consultant Paediatric Anaesthetist, identified the lack of information about general anaesthesia for children with special needs while contributing to the development of information resources for children and young people for the Royal College of Anaesthetists and Association of Paediatric Anaesthetists.

A visit to Mossbrook Special School and a postal survey of parents with children at seven Special Schools in Sheffield confirmed the problem and offered solutions. Parents were anxious about anaesthesia and surgery and wanted resources to help prepare their child for a hospital visit. Symbols, sign language and structured time-line approaches were used both in school and at home and could be adapted for hospitals.

We worked together with Dr Judith Short and hospital play specialist Lisa Broxholme to create new symbols to support anaesthetic procedures and developed communication resources which they now use routinely.

"There is no doubt that, for the patients who are familiar with symbols from school or home , the availability of the hospital timeline and flash cards is hugely beneficial. I have had patients comply with an anaesthetic induction, using the symbols as prompts, who have had to be forcibly restrained in the past."

The resources can be used before the hospital visit, to introduce the patient to the procedures that are likely to take place and familiarise them with the symbols.

The flashcards can be cut up and used as cue cards during the visit to prepare the patient for what is happening or going to happen next. These can be arranged on a board or vertical strip on a wall, allowing the child to work through them in sequence and discard a symbol as each step is completed. They also allow the procedures to be practised at home prior to the visit.

For patients requiring sedative premedication, flashcards can be used to encourage medicine to be taken. Eating, drinking and going home provide rewards at the end of the time-line.

Widgit has now developed health resources covering a range of topics including day surgery and diabetes. These were being used in hospitals and out patient clinics.

"We use the symbols on TAU with great success. We always take feedback from the parents in the form of a questionnaire and have had a very positive response. Having the symbols has helped many children cope with the hospital environment and has turned what would've been a very daunting and frightening time into a more positive experience."

Dr Judith Short, Consultant Paediatric Anaesthetist
Lisa Broxholme, Theatre Admissions Unit Play Specialist