I don’t know that I’ve seen any specific volumes that are allowed for clear liquids prior to surgery. Do you guys generally care how much water or black coffee someone drinks up to two hours before surgery? I looked at the ASA guidelines, and I don’t think it gave any specific amount. Just curious what your practices are.
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NPO clears
Started by Lecithin5
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They can be waterboarded and I'll still say 2 hours
What if there is just a little amount of cream in the coffee?
6 or 8 hours depending on which side of the bed you woke up on
it was kind of a joke because i get that phone call all the time from nurses.
When a patient says it’s “a tiny amount of cream” it absolutely was a latte
cittykat
Full Member
Because if anything happens they can say they told you so. "A little bit" means whatever they want. They want you to acquiesce because it was just a little.
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Not unreasonable. All these NPO guidelines are minimums, and patient specific factors can make you extend them. It seems you've honed in on the BMI, diabetes and Gerd concerns that may slow gastric emptying and/or increase aspiration risk
I hope you didn’t find a cancer because this person would have a rough surgery and recovery
I don’t remember too much. If I didn’t remember it was probably benign.
That bmi is a midwest medium
I sometimes forget how easy my job actually is. The vast majority of patients are healthy, thin, and well looked after.
Yeah, it's no beuno when you're in cath lab or EP and the average BMI is higher than the average ejection fraction.
And they want sedation ala iv general anesthesia without an airway
Amen. I don't even start sweating about an epidural until they break 60 BMI.
Other issue is these are Stand a lone GI centers. No vent. Obviously the patient had commercial insurance. I’m sure if the patient were Medicare they would punt them to the inpatient hospital unit to do these cases. So stand a lone outpatient GI really pushed the limits
cittykat
Full Member
Gotta be desperate to staff a place like that and nobody is that desperate these days. Just say no.
At least it was diet, gotta take care of oneself
The ASA guidelines are based on gastric emptying studies in healthy patients. They used specific volumes and I can’t remember what they are but its probably like 12-16 ounces or something. So while many people use the guidelines like a Bible, they aren’t by any means fool proof for every single patient and the ASA does not even claim that it is the case.
I think this is sensible. I know most people say that they don’t care what the volume is as long as it has been two hours. But you can’t tell me that if you guzzle down liters of diet sprite or black coffee, that this won’t affect gastric dynamics.
Esophagitis, gastritis and random stomach biopsies.
Gastric ultrasound!
Diet? You sure about that?
