NPO status changes for EGDs?

[NickiLaughs, ADN, BSN, RN]

Hey all!

So our protocol for endoscopies has always been NPO after mn & clear liquids morning of. 
Our medical director heard I rescheduled someone for drinking an ensure 4 hours prior.  (I always double check with doc & he wanted patient rescheduled)

Med Director thinks we should have done procedure and it's only NPO for ANY liquids 4 hours before.  We use fent/versed  Is this a change a lot of people are doing?  What's your guys rules?

A couple docs are already gathering information to refute this and aren't comfortable with the change.

 

Thanks!

[MaxAttack, BSN, RN]

Not for endoscopies specifically, but my unit follows the ERAS protocol that's in line with ASA Guidelines:

https://pubs.asahq.org/anesthesiology/article/126/3/376/19733/Practice-Guidelines-for-Preoperative-Fasting-and

Quote

Clear liquids† may be ingested for up to 2 h before procedures requiring general anesthesia, regional anesthesia, or procedural sedation and analgesia.

...

A light meal or nonhuman milk may be ingested for up to 6 h before elective procedures requiring general anesthesia, regional anesthesia, or procedural sedation and analgesia.

If your medical director wants to go against ASA guidelines I hope they have a stack of evidence to back them up. It sounds like a paper pusher prioritizing cases over safety, though.

[Rosalie Blythe, BSN, RN]

Ensure is not clear fluid so it should be 6-8 hours before. From where I work it should be at least 8 hours from the ensure