Introduction All patients are required to fast before general anaesthesia in order to reduce the risk of aspiration on induction. Fasting prior to surgery ensures minimal volume and acidity of stomach contents. Current guidelines suggest that adult patients should fast before undergoing surgery for 6 h with regard to food and 2 h for clear fluids.1For emergency surgery, it is advised that the patient be treated as though they have a full stomach, unless there has been adequate time to allow for following of normal guidelines. Control over operative and therefore fasting times for emergency surgery can be challenging. This audit aims to compare local practice to fasting guidelines, with respect to emergency surgery.
Method This is a prospective audit of adult patients undergoing emergency surgery for a six-month period, from August 2014 to January 2015 in our District General Hospital. The data collection was randomised to various different working days throughout this time frame in order to avoid bias. Using current guidelines, the standard was set for fasting of 6 h for food and 2 h for clear fluids.
Results 35 adult patients underwent emergency general surgery over 17 working days in the audit period. Paediatric patients were excluded. Patients ranged from 21–89 years, with an average age of 57 years. The average starvation for food was 22 h 18 min, with only one patient meeting the current guidelines. The average time for starvation for clear fluids was 10 h 39 min. The documentation around the administration of IV fluids was unreliable and therefore could not be analysed.
Conclusion Patients were inappropriately starved pre-operatively, unintentionally in the majority of cases. The findings are unlikely to be specific to our hospital. These, along with the review of current fasting guidelines due to be published this year, should prompt a review of the delivery of emergency services. Both our general surgical and anaesthetic departments are currently looking into educating all members of the team regarding feeding times and the introduction of preoperative drinks, similar to those given prior to elective surgery.
Disclosure of interest None Declared.
AAGBI Safety Guideline 2010 January, ‘Fasting guidelines in adults and children’, in Pre-operative Assessment and Patient Preparation, The Role of the Anaesthetist, The Association of Anaesthetists of Great Britain and Ireland, London, England, pp. 30–3