Modesto Hospital Lets Children Drive Mini Cars Into Surgery

Originally published 2019-05-28.

At Doctors Medical Center in Modesto, California, some of the youngest surgical patients do not get wheeled into the operating room on a trolley. They drive themselves there in a battery-powered mini car. The idea came from a pre-op nurse, Kimberly Martinez, and the hospital offers it to children aged roughly 2 to 7. The point is simple: a child who is busy steering, honking and choosing music is far less likely to panic in the corridor, and a calmer child makes for a calmer parent.

Below you will find how the Modesto cars work, why the moment of separation before surgery is so hard for small children, and practical ways any family can prepare a child for an operation, whether or not their hospital has a fleet of toy cars.

How the Modesto mini cars work

CBS News reported the programme on 6 April 2019. The hospital has two cars: a black Mercedes that the medical centre bought, and a pink Volkswagen Beetle donated by a staff member and her family. Both are built for children between about 2 and 7 years old.

They are more than plastic shells. Each has a stereo with preloaded songs and an MP3 player, working headlights, taillights and dashboard lights, doors that open, a seatbelt and a horn. A child can drive, or a staff member can steer by remote control when a young driver is too small or too sleepy from pre-medication.

According to CBS, Martinez said the children "light up and in most cases, their fears melt away" when they learn they can ride into the operating room. She also pointed to the parents: when they see their child relaxed, they relax too.

This hospital lets kids drive themselves to surgery in toy cars to overcome fear :) ♥️https://t.co/kTOUzsulEt

— Dharmaraj Solanki (@NGOwallah) April 10, 2019

Why the walk to the operating room is so hard

For many young children, the frightening part is not the operation itself, which they will sleep through, but the build-up: a strange building, people in masks, hunger from fasting, and the moment when a parent has to stay behind. Anxiety before surgery is common in this age group and has been studied for decades by paediatric anaesthetists.

A very anxious child can be harder to settle when the anaesthetic starts, and parents' own fear tends to show in their faces and voices. That is why many children's hospitals use distraction: tablets, bubbles, play specialists, a favourite toy that travels into the theatre, and in some places, cars. The Modesto team's idea turns a passive and scary transfer into an activity the child controls, which is exactly what small children lack in a hospital.

A fair caveat: the evidence for the cars is mostly what staff and parents observe. Reduced worry on the way in is a real benefit, but it is not proof of better surgical results, and the hospital has not claimed that.

The idea caught on far beyond Modesto

When CBS shared the story, it spread quickly on social media, and plenty of adults joked that they wanted the same treatment for their next operation. Similar schemes have since been reported at other hospitals, typically funded by donations, with ride-on cars given by local businesses or charities.

When I have my next surgery, I want a car to drive to the OR!! https://t.co/6xEl4kAI4Z

— T1n@ (@T1nA_) April 10, 2019

If your local children's hospital does not have one and you would like to help, ask its charity or volunteer office first. Hospitals have rules on cleaning, battery safety and storage, so a conversation beats turning up with a gift.

ROAD TO RECOVERY: This medical center gives kids mini cars to drive into surgery to reduce their stress and anxiety 💓 https://t.co/78Ind261CN pic.twitter.com/Ltdt2lUs27

— CBS News (@CBSNews) April 6, 2019

How to prepare a child for planned surgery

An emergency gives no time to prepare. A planned operation does, and that time is valuable. These ideas come from common paediatric practice; always follow the advice of your own hospital team.

Talk early enough, but not too early

Small children have little sense of time, so a few days' notice is usually plenty for a pre-schooler, while older children may want to know earlier and ask more questions. Use simple, honest words. Explain why the operation is needed and what will happen step by step, from arriving at the hospital to waking up afterwards.

Choose words carefully

Phrases such as "put to sleep" can sound alarming, because some children know that is what happens to pets that never come back. Many nurses prefer "a special sleep medicine so you don't feel anything" and they always add that the child will wake up again when the doctors are finished. Avoid promising that nothing will hurt at all; say instead that the team will help with any soreness.

Let the professionals help

Children commonly worry about three things: that it will hurt, that they will wake up during the operation, or that they will not wake up. An anaesthetist or a hospital play specialist can answer those fears directly. Ask whether the hospital offers a pre-admission visit or a video tour, and whether a parent can stay until the child falls asleep.

Practise through play

Toy doctor kits, picture books about hospital stays and role-play with a teddy who "has an operation" help a child rehearse what is coming. Pack a comfort item and let the child help choose it.

Looking after yourself as a parent

Children read faces long before they understand words. If you are visibly tense, they will be too. A few things that help parents:

• Write down your questions before the pre-op appointment, so you leave with answers rather than worries.
• Know the fasting rules exactly. They vary by hospital and by age, and getting them wrong can delay the operation.
• Plan the practical side: time off work, care for siblings, and someone to drive you home.
• Agree with your partner or a friend who will go in with the child, ideally the calmer of you.
• Expect some drowsiness, thirst, a sore throat or sickness after a general anaesthetic. These usually pass within hours, but call the hospital if you are worried.

What to remember

The Modesto mini cars are a small, cheap idea that changes how a frightening morning feels for a child and their family. Most hospitals will not have them, but the principle behind them travels well: give the child information they can understand, something to do, and a calm adult beside them. For anything about your own child's operation, talk to a doctor or the surgical team.

Sources: CBS News, 6 April 2019; NHS: General anaesthesia; Twentytwowords.