Surgery Guidelines and Recommendations

Main Content

Preoperative Fasting Protocol

Definitions

  • Intubated patients: Patients who have a cuffed endotracheal tube in place (either ET or tracheostomy)
  • NPO: “nil per os”: No intake by mouth or through a tube through the GI tract
  • Enteral feeds: artificial method to provide nutrients and/or water to the stomach or small bowel through a surgically placed or inserted through the oral or nasal pathway

Protocol

  • Prior to general anesthesia or procedures, non-intubated patients must be NPO for a minimum of 6 hours.
  • Intubated patients having either airway surgery (includes tracheostomy) or planned reintubation (such as thoracotomy/thoracoscopy) require NPO a minimum of 6 hours.
  • Intubated patients having planned surgery on the GI tract require NPO for 6 hours.
  • Intubated patients prior to procedures requiring the Trendelenburg position require 30 minutes of NPO status (can be stopped on call to OR/IR). Gastric tubes will be aspirated and contents discarded at this time.
  • For all other intubated patients, enteral feeds can be continued until the time of departure to the operating room, interventional radiology, or procedure suite. This includes any patient who will be prone during surgery or extubated post-operatively. Gastric tubes will be aspirated and contents discarded by the bedside nurse prior to departure from the ICU in the presence of anesthesia.
  • Following non-abdominal surgeries, enteral nutrition should be resumed at previous rate on arrival back to ICU unless otherwise directed by the surgical team.

 

Disclaimer: The contents of this application are for the exclusive and specific use of University of Mississippi Medical Center faculty and trainees. Any other use is neither authorized nor sanctioned by UMMC. The information is for educational purposes only. The contents of this application are for the exclusive and specific use of UMMC faculty and trainees. Any other use is neither authorized nor sanctioned by UMMC. The information is for educational purposes only.