Why are pre-op patients NPO?Register Today!
- by mac2010 Sep 19, '08Hi,
I am just wondering....Why are pre-op patients kept NPO? What is the rationale behind this?
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- Sep 19, '08 by Daytonitewhen they are under general anesthesia and unconscious, if they get nauseated from the many drugs they are given while anesthetized they will have nothing in their stomach to vomit and therefore aspirate into their lungs to cause hypoxia and brain death.
- Sep 19, '08 by mac2010oh, ok thanks very much! That was a burning question for you and I was itching to find out why...
- Sep 20, '08 by Daytoniteif you were with me in a clinical and asked the question i would just tell you that you don't want the patient to puke and if they do, you don't want the puke to consist of food particles that could be aspirated into the airway and cause the patient to suffocate. every patient undergoing general anesthetic must be npo for at least 8 hours before the anesthesia. if there is ever a doubt, keep the patient npo until their food and fluid status can be clarified. it is easier to apologize to a patient for a few hours of an npo mix up than deal with an upset doctor and patient for a full day delay of a surgery or procedure that requires an npo status preparation and scheduling.
did you ever see the movie the verdict from 1982 with paul newman? the verdict is a medical malpractice story about a surgeon who was covering up the fact that he had altered a patient's pre-op record post operatively. when the patient vomited post operatively and aspirated the vomitus causing her to be in a permanent vegetative state, the surgeon covers his butt from a possible lawsuit when he realizes he had forgotten to check on whether the patient had eaten just prior to operating. the audience doesn't learn that until the dramatic ending, however. the surgical nurse who assessed the patient preoperatively produces a xerox copy of the untampered original pre-op questionnaire she made after the patient's tragic episode thinking she might need it some day. she blows the case wide open at the end of the movie when she pulls out this xerox copy out of her purse that proves the doctor altered this document. nurses everywhere probably want to hug and kiss her.
- Sep 20, '08 by vamedic4Daytonite...I just have to say: You so completely rock!! You're such an asset to this forum.
- Sep 20, '08 by Nursing-StudentQuote from daytonitethanks for answerwhen they are under general anesthesia and unconscious, if they get nauseated from the many drugs they are given while anesthetized they will have nothing in their stomach to vomit and therefore aspirate into their lungs to cause hypoxia and brain death.
- Feb 22, '09 by JantRNI work in the operating room. Recently I had a patient brought down to the OR who suffers from dementia & DM. The nursing documentation stated NPO since MN the night before. However during the pre-op interview, the patient stated that she had eaten breakfast. The anesthesiologist asked that I call the floor to verify the NPO status.
Upon calling the RN, she stated that they caught the patient eating from her own private stash of cookies, but she only ate 1 or 2... and they were sugar free.
This caused the anesthesiologist to have to use rapid sequence intubation to prevent aspiration. The surgeon performing the operation let the family know that the patient need dialysis ASAP and could not wait anylonger for the surgery. (It would have to be 8 hours for DM pt 6 hrs for a non-DM pt to safely perform regular sequence intubation.)
I really think there needs to be more teaching on the importance of not only documenting correctly (ie not lying!!!!!) AND the rational behind keeping a patient NPO.
Even sucking on a mint will cause an increase in gastric juices. You have to think about the paralytics used in anesthesia too. It doesn't have as much to do with the drugs making the patient nauseated as it does with the act of intubating a patient.
- Feb 22, '09 by truern
- Feb 22, '09 by JantRNTook me a while to get through that truern. Whats so frustrating to me is that the RN in my case didn't understand either:#1 how important a couple of cookies could be.. or #2 how important it is to tell the truth....
- Mar 13, '10 by blackfoot45I saw your reply..I need help from anyone, I am due to have Rectocele and Cystocele repair. problem is I'm a rape victim, 7 years worth ( 7 yrs old to 14 yrs old) and at 19 what i thought was the Dr's finger during an exam wasn't his finger...I need to know in detail what to expect in the preop by the nurses,,,I don't handle this well ....being touched or exposing myself please help