Outpatient Surgery Magazine

Why Can't He Eat or Drink After Midnight? - March 2016 - Subscribe to Outpatient Surgery Magazine

Outpatient Surgery Magazine, providing current information on Surgical Services, Surgical Facility Administration, Outpatient Surgery News and Trends, OR Excellence and more.

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Page 49 of 160

He's not the only one facing the major stress of surgery while hun- gry, thirsty, anxious, nauseated and generally uncomfortable. Surgical facility leaders across the nation are generally slow to abandon out- dated pre-op fasting policies, according to last month's Outpatient Surgery Magazine online survey of 153 surgical facility leaders. • NPO by midnight. More than half (54.8%) of our survey respondents still follow the overly rigid fasting instructions of NPO-by-midnight totally or in some form. "No one will die from not eating for one morning," says Brett Swain, RN, an OR nurse at the Alta Bates Summit Medical Center in Oakland, Calif. "People who aspirate are at markedly higher risk of pneumonia and death. It isn't worth the risk- benefit ratio. You don't know the entire picture of the patient. Is he on narcotics that will slow gastric emptying? Is he borderline diabetic but not on meds yet?" • Clear liquids. Even though decades of research support the safety and health benefits of consuming clear liquids until a few hours before surgery, surgical facility leaders routinely instruct patients to fast for excessively long pre-op periods. Only about one-third (31.1%) of our survey respondents tell patients they can drink 2 hours before their procedures, while 43% instruct patients not to drink anything after midnight. When the American Society of Anesthesiologists published its first practice guidelines for pre-operative fasting for healthy patients undergoing elective surgical procedures 17 years ago, it declared it safe for such patients to "have clear liquids up to 2 hours prior to surgery." "We give our patients a specific time to stop clear liquids. Generally it is 2 to 2 1 ⁄2 hours before their arrival at our center," says the director of an ENT surgery center. "If the patient is to arrive at 0830, we would tell her to stop the clear liquids at 0600. It works out to be about 3 5 0 • O U T PA T I E N T S U R G E R Y M A G A Z I N E • M A R C H 2 0 1 6

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