NPO before surgery is nonsense

[Guest219794]

.....or, maybe it isn't. I figured I'd ask those of you that know.

How long does it take for a couple of ounces of water to be absorbed? what is the possible hazard of a pt drinking a little water a couple hours prior to surgery?

As an ER nurse, I keep my pt's NPO when ordered, but don't really know why. I get why they shouldn't have a cheeseburger and milkshake, but ice chips?

It feels like surgeons don't trust pts, or nurses, for that matter, to follow instructions.

For example: pt A and pt B are both scheduled for surgery tomorrow. A at 0600, B at 1100. Both are NPO after midnight. At 1130, pt A has a huge meal. At 0500 pt B would like some water, but can't have any.

Can somebody please explain the physiology here?

hherrn

[PMFB-RN, RN]

samta69 said:

The way I see it, the risk of complications from having to get out of bed and take a BM when I'm supposed to be on my back so that I don't bleed after the procedure is a far higher risk to my health.

Any thoughts from anybody?

*** LOL! "Get out of bed and take a BM"!!! Not if you are my patient. Bedpans and dirty beds are just things to be dealt with as part of my job. You bleeding cause I allowed you to get out of bed for something so trivial as to have a BM would cause me to have to fill out all kinds of paper work. I take no chances when it comes to the possibility of having to do more paper work. Not a chance you would be getting out of that bed.

[canesdukegirl, BSN, RN]

I think that the rule of NPO p mn is a good one. It is less confusing for the patients. I have had to move cases up from 1300 to 0800 many many times, so this allows for the patient to get on with the surgery earlier than normal. Sips with meds in the am is totally ok, as long as it is WATER.

I was interviewing a pt some time ago before surgery, and did the normal questions. When I asked him if he had had anything to eat or drink after midnight, he said, "Uh...yeah. I had me a 40 oz of King Cobra in the car on the way here cuz I was so nervous and all. Doc SAID I could have anything clear. Beer is clear." Of course we laughed about this, canceled the case and are still debating about beer being a clear!

[sharkdiver]

canesdukegirl said:

I was interviewing a pt some time ago before surgery, and did the normal questions. When I asked him if he had had anything to eat or drink after midnight, he said, "Uh...yeah. I had me a 40 oz of King Cobra in the car on the way here cuz I was so nervous and all. Doc SAID I could have anything clear. Beer is clear." Of course we laughed about this, canceled the case and are still debating about beer being a clear!

LOL!

While the beer might qualify as a clear liquid, I suspect the ETOH he had on board was more than enough reason to cancel.

That said, there are some surgeries where NPO is not applicable. The last three I've had were outpatient surgery done with either a local or a regional nerve block & with no sedation - didn't even have an IV in (other than for the bier block itself). In all three, when we were going over the instructions at last appt. before surgery, the surgeon told me to ignore the NPO part as it wasn't applicable.

[jessrene, LPN]

We always say 'no food' 8 hours before surgery or 'no food after midnight', whichever comes first, and clear liquids are ok up to 3 hours before arrival time. So sometimes 'no food' starts before midnight if they are an am case, and the 3 hour cut off for fluids may be at 3am, but at least they know they can have a sip in the night if they wake up for some reason. Also, we allow as small a sip as possible as early as possible to get down essential am meds.