What about Jello? Is that a clear liquid?
Had a huge argument with an attending about this one recently. This obese 13 y.o. kid was hungry and complaining because she had to wait to go for surgery (unexpectedly prolonged case before hers). The scheduler told the nurse to give her some Jello. I took her into the OR, found out that she'd eaten Jello about 3 hours beforehand. I called the scheduler (who is an anesthesiologist) from the OR with the patient still on the Gurney and he said it was okay, go ahead and start the case. I told him that I didn't think Jello, although you often here it stated, is considered a "clear liquid" and that we should at least delay until four hours. He basically told me that I was the resident (i.e., *****) and that if I delayed the case, he'd write us up for the delay (how's that for getting your back?). Me and my attending were pissed, although this particular attending is so spineless that he didn't want get in the middle of it (can you believe that?).
I gave her Reglan, we started the case, intubation went fine. Nearing the end of the case, just for sh*ts and giggles, I dropped an OG tube down the patient. Guess what happened? I sucked out about 200mL of a orangy, frothy gelatinous substance that looked suspiciously like Jello.
I think what pissed me off the most was that the scheduler was in no other way connected to the case. His name never appeared anywhere as authorizing the Jello. And, knowing this schmo, if something HAD happened (i.e., aspiration), then he sure as hell wouldn't have stepped up and taken responsibility. Hell, I'm positive he never even went and saw the kid but just authorized it on the phone.
Now, we can debate the pH of Jello and whether or not it would've damaged the lungs, but in my book it's better not to conduct such experiments on children, at least without IRB approval. Next time, I cancel the case and/or we wait a full six hours.
-copro