NPO clears

[Lecithin5]

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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.

 

[coffeebythelake]

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.

They can be waterboarded and I'll still say 2 hours

 

[UscGhost]

Any amount is fine

 

[Gator7]

Clears = 2 hours

Clears + 10 ERAS horse size pills = 5 seconds

 

[dmk5n]

What if there is just a little amount of cream in the coffee?

 

[coffeebythelake]

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

 

[dmk5n]

it was kind of a joke because i get that phone call all the time from nurses.

 

[Twiggidy]

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]

When a patient says it’s “a tiny amount of cream” it absolutely was a latte

Why even bother with a tiny amount?

 

[coffeebythelake]

Why even bother with a tiny amount?

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.

 

[aneftp]

64 ounces (a full 2 liter of Diet sprite) on bmi 52 for colonoscopy 2 hrs before with history of diabetes and reflux.

Yes or no? I pushed him back 4 hrs. I ain’t playin that game.

 

[coffeebythelake]

64 ounces (a full 2 liter of Diet sprite) on bmi 52 for colonoscopy 2 hrs before with history of diabetes and reflux.

Yes or no? I pushed him back 4 hrs. I ain’t playin that game.

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

 

[ambiturner]

64 ounces (a full 2 liter of Diet sprite) on bmi 52 for colonoscopy 2 hrs before with history of diabetes and reflux.

Yes or no? I pushed him back 4 hrs. I ain’t playin that game.

I hope you didn’t find a cancer because this person would have a rough surgery and recovery

 

[aneftp]

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.

 

[coffeebythelake]

I hope you didn’t find a cancer because this person would have a rough surgery and recovery

That bmi is a midwest medium

 

[cchoukal]

I sometimes forget how easy my job actually is. The vast majority of patients are healthy, thin, and well looked after.

 

[Iso4ane]

That bmi is a midwest medium

Yeah, it's no beuno when you're in cath lab or EP and the average BMI is higher than the average ejection fraction.

 

[coffeebythelake]

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

 

[abolt18]

That bmi is a midwest medium

Amen. I don't even start sweating about an epidural until they break 60 BMI.

 

[aneftp]

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]

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

Gotta be desperate to staff a place like that and nobody is that desperate these days. Just say no.

 

[Account1]

64 ounces (a full 2 liter of Diet sprite) on bmi 52 for colonoscopy 2 hrs before with history of diabetes and reflux.

Yes or no? I pushed him back 4 hrs. I ain’t playin that game.

At least it was diet, gotta take care of oneself

 

[Guillemot]

64 ounces (a full 2 liter of Diet sprite) on bmi 52 for colonoscopy 2 hrs before with history of diabetes and reflux.

Yes or no? I pushed him back 4 hrs. I ain’t playin that game.

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.

 

[Guillemot]

 

[Lecithin5]

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.

 

[MirrorTodd]

I don’t remember too much. If I didn’t remember it was probably benign.

Esophagitis, gastritis and random stomach biopsies.

 

[coffeebythelake]

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.

Gastric ultrasound!

 

[DesiredMemberName?]

64 ounces (a full 2 liter of Diet sprite) on bmi 52 for colonoscopy 2 hrs before with history of diabetes and reflux.

Yes or no? I pushed him back 4 hrs. I ain’t playin that game.

Diet? You sure about that?