Fasting Guidelines

Peri-operative Fasting

20/04/23, 6 slides, total revision time approx. 4 minutes

• Fasting is recommended for all elective operations.

• Recommended fasting times can vary a lot.

• The purpose is an empty stomach, with no acid, no food contents = an empty stomach.

• To reduce the risk of pulmonary aspiration.

• Excessive fasting is harmful to patients.

• Especially elderly, children and the unwell ones.

• We all need approx. 100 mls per hour of fluid per hour.

• Unwell patient have a lot of reasons not to be excessively fasted.

• They have not eaten or drank for days, traumatic loss of blood, etc; other losses like vomiting etc.

• They have very little reserve to compensate.

Recommended guidelines (adults)

• Solids – 6 hours• Milk – 6 hours• Clear Fluids like water – 2 hours• Black coffee or black tea – speak to your

anaesthetist (4 hours fine by me personally).

• No coloured juices, squash, chewing gums, etc for 6 hours.

• If patients are saying they are thirsty, you have fasted them too much, or not corrected their fluid deficit. Just ask them to drink.

• We understand that once they are on the op list, keeping them fasted is safer, but they all certainly can drink water till 6 AM.

Recommended reading

• http://www.aagbi.org/sites/default/files/preop2010.pdf - Jan 2010

• http://www.rcn.org.uk/__data/assets/pdf_file/0009/78678/002800.pdf - Nov 2005