Fasting guidelines Flashcards
What is the aim of fasting prior to anaesthesia or sedation?
To decrease the risk of perioperative regurgitation, which may result in aspiration syndrome.
Aspiration syndrome can lead to complications such as chemical pneumonitis, bacterial pneumonia, or airway obstruction.
What may occur if foreign material and/or gastro-intestinal fluids are aspirated into the lungs?
It may result in chemical pneumonitis, bacterial pneumonia, or airway obstruction.
This can lead to patients requiring treatment in critical care units.
What are the effects of prolonged fasting from fluids for more than 6 hours?
It fails to achieve an optimally empty stomach and may have deleterious metabolic effects as well as an impact on patient well-being.
Prolonged fasting can negatively affect patient recovery and comfort.
What type of fluid may improve gastric emptying during fasting?
Clear fluid, particularly carbohydrate-rich fluid.
This can also mitigate the metabolic and psychological impact of fasting.
What is the safe volume of clear fluids that can be administered to adults prior to surgery?
Up to 400 mL of clear fluids 2 hours prior to surgery.
This volume may vary based on individual patient factors.
What are considered clear fluids?
Water, carbohydrate-rich fluids, pulp-free fruit juice, clear cordial, black tea, and coffee.
Clear fluids exclude those containing particulate matter, soluble fiber, milk-based drinks, and jelly.
What are the fasting recommendations for adults having an elective procedure?
Limited solid food may be taken up to six hours prior to anaesthesia, and clear fluids may be taken up to two hours prior.
This ensures patient safety and minimizes aspiration risk.
What are the fasting recommendations for children over six months of age prior to an elective procedure?
Limited solid food or formula may be given up to six hours, breast milk up to four hours, and clear fluids (no more than 3ml/kg/hr) up to one hour prior to anaesthesia.
These guidelines help manage the risk of aspiration in pediatric patients.
What are the fasting recommendations for infants under six months of age prior to an elective procedure?
Formula may be given up to four hours, breast milk up to three hours, and clear fluids (no more than 3ml/kg/hr) up to one hour prior to anaesthesia.
Adjustments are made for the age and dietary needs of infants.
When can prescribed medications be taken prior to anaesthesia?
With a sip of water less than two hours prior to anaesthesia unless otherwise directed.
This applies particularly to oral hypoglycaemics and anticoagulants.
What should be considered for patients with an increased risk of gastric regurgitation?
An H2-antagonist, proton pump inhibitor, or other agent that decreases gastric secretion and acidity.
This helps to further reduce the risk of aspiration during procedures.
True or False: The fasting guideline applies to all patients without exception.
False.
It may not apply to patients at increased risk of perioperative regurgitation or vomiting, such as those having emergency procedures.
What should be done for patients who have had bariatric surgery regarding fasting?
The practitioner should exercise discretion regarding fasting times versus the risk of aspiration.
Individual patient factors may necessitate deviation from standard guidelines.
What is the recommendation regarding chewing gum before anaesthesia?
Chewing gum should be discarded.
The risk is primarily due to it being a foreign body rather than increasing gastric content.
