What We Do:

The goal of the Children’s Center for Perioperative Optimization (CCPO) is to make anesthesia and procedures as safe and stress-free as possible for pediatric patients.   You or your child is referred to our center by your physician or surgeons based on medical history and type of procedure planned.  Staffed by Pediatric Anesthesiology Attendings with Pediatric Anesthesia Fellows and Residents, our CCPO care team is committed to ensuring that our pediatric patients and families are medically prepared for the scheduled surgery and educated about the appropriate anesthesia care plans in place.

Pediatric preoperative visits can occur in two different locations, the Johns Hopkins Outpatient Center on the East Baltimore Medical Campus or the David M. Rubenstein Child Health Building.

Visit Types
We offer two types of appointments at our center depending on the patient’s specific needs, either a Preoperative Visit or an Anesthesia Consult.  The appointment time with our center will take approximately one hour, which does not include preoperative lab or radiologic testing that may be needed.

Children’s CPO Faculty and Clinical Associates
Sally Bitzer, MD, Director
Ivor Berkowitz, MD
Rahul Koka, MD
Joann Hunsberger, MD, MS
Barbara Vickers, MD, MPH
Monica Williams, MD

Please bring the following with you for your Preoperative Visit or Anesthesia Consult:

  • Insurance Information and a Photo ID
  • List of the patient’s current medications along with dosage and frequency of use
  • Name and phone number of the patient’s Primary Care Physician and any Specialists that the patient sees
  • Copies of any outside testing (i.e. Previous EKG, Stress tests, Echocardiograms, lab/blood tests, etc.)

Please check with the patient’s insurance company before coming to the Preoperative Visit or Anesthesia Consult to check if you can have the preoperative testing done at Johns Hopkins. If the patient cannot have the testing here, have the surgeon’s office give the patient orders for which tests need to be done and get these done at an outside facility (preferably before the Perioperative Visit/Anesthesia Consult date).

Please note, the patient DOES NOT NEED TO FAST for the Preoperative Visit or Anesthesia Consult. However, if the patient is having any special radiologic procedure scheduled by the surgeon’s office, (i.e. CAT scan or MRI) it may require fasting so please check with the surgical service.

Medical Evaluation
The patient will have vital signs checked by one of our Certified Medical Assistants or nurses prior to meeting with a provider. Then the patient will see one of our providers for an Anesthesia-focused History and Physical Exam. The patient and his/her guardians will be given detailed instructions about when and where to report for surgery along with directions as to which medications to take the morning of surgery. We will also discuss fasting instructions, to determine when the patient should stop eating and drinking prior to surgery.  We realize this is may be a stressful time and we encourage the patient and/or guardians to write down any questions and we will do our best to answer them. We ask that for no more than 2 visitors to accompany the patient inside the exam room to reduce distractions during the visit.

Preoperative Testing:
The patient may need lab work, EKG, chest X-ray or other studies after the preoperative appointment and in preparation for surgery. This will be determined by the surgeon and the provider that is evaluating the patient on the day of the preoperative appointment. If the patient has had any of these tests done recently outside of Hopkins, please bring the results with on the day of the preoperative appointment.

For appointments in the Rubenstein Health Building, laboratory testing is conveniently located close the the Preoperative Clinic.  The patient will be directed where to go for that testing.  For appointments in the Johns Hopkins Outpatient Center, the Express Testing is located on the first floor of the Outpatient Center next to the Pharmacy. They draw blood, collect urine specimens and perform EKG’s.  Our Radiology Department is located on the fourth floor directly across from the elevator. The laboratories are generally open Monday through Friday from 7:30am – 5:30pm, except holidays.

Before your surgery, you will be given NPO instructions. “NPO” is a Latin abbreviation for “nothing by mouth.” Food and drink taken before anesthesia can cause problems such as choking or vomiting. There are a few rules about eating and drinking that can prevent these problems. If you have been given specific instructions from your surgeon regarding consumption of liquids preoperatively, then please follow those instructions.

  • NO solid foods, non-clear liquids including milk, milk products, creamers, gum, mints, or candy after midnight the night prior to your surgery.
  • We encourage consumption of CLEAR LIQUIDS after midnight the night before your surgery as allowed by your surgeon. Acceptable Clear Liquids are listed below.
ACCEPTABLE CLEAR LIQUIDS NO!
Water
Gatorade/Powerade sports drinks
(avoid red if having colorectal procedure or surgery)
Apple juice (no pulp)
Black coffee with or without sugar
Tea with or without sugar
Milk
Cream or other milk-based products
Coffee with cream/milk
Tea with cream/milk
Orange juice
Any juices with pulp
Apple Cider
Tang or any powder-based drink

Full Pediatric NPO Guidelines: Arabic, English, French, Spanish

*These guidelines are in Adope PDF format – please click here to downlad a free version of the software.

Pediatric preoperative visits can occur in two different locations, the Johns Hopkins Outpatient Center Campus or the David M. Rubenstein Child Health Building, both on the East Baltimore Medical.

The David M. Rubenstein Child Health Building is located at 200 N. Wolfe Street. Click here for map, parking and directions.

The Johns Hopkins Outpatient Center is on the East Baltimore Medical Campus at 601 N. Caroline Street. Click here for map, parking and directions.

Parking
For appointments at the David M. Rubenstein Child Health Building, parking is located in the Orleans Street Garage.  The entrance to the garage is off of Orleans Street, across from the Johns Hopkins Hospital Main Entrance.

For appointments at the Johns Hopkins Outpatient Center, parking is located next to the Outpatient Center in the McElderry Garage. The entrance to the garage is located off of North Caroline Street.

Food and Beverage Availability
There are several dining options that are located in the Johns Hopkins Outpatient Center. The Women’s Board Coffee Shop is on the first floor of the Outpatient Center and is open Monday through Friday, 7:30AM – 3:30PM. The 601 Grille is on the second floor of the Outpatient Center and is open Monday through Friday, 6:00AM-2:30PM.  There is a dining area that is located in the Rubenstein Building.

Internet Access
If you have a mobile device with you, free wireless access is available as “JHGuestnet.” Mobile devices are allowed in the waiting room but should be powered off once inside the exam room.