By: 8 January 2015
Trauma list fasting times audit – the water sip challenge

An audit of trauma list fasting times conducted at Queen Elizabeth Hospital, Woolwich, by Claire Daly and co-workers

For safety reasons, patients should not eat or drink immediately before anaesthesia. This is known to reduce the incidence of regurgitation and pulmonary aspiration of gastric contents [1]. Fluid deprivation can be unpleasant for children, but also for adults [2]. Shortening the fluid fast may lead to less anxiety pre-operatively and less post-operative nausea and vomiting [3], and new guidelines now actively encourage patients to drink two hours prior to anaesthesia [2]. Evidence for this was recently reviewed in a Cochrane meta-analysis, which found there was no increased likelihood that patients who received clear fluids up to two hours prior to anaesthesia were at an increased risk of adverse outcome than those who were fasted for longer. Results showed nearly identical stomach pH and gastric fluid volumes [4].

Due to the often unpredictable nature of the trauma list, it was noticed that many patients were coming to trauma theatre with prolonged fasting times. The patients were often elderly and frail or paediatric cases, in whom prolonged fasting can significantly…

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Claire Daly is a CT1 (Anaesthetics), Danielle Factor is a consultant anaesthetist, Victoria Buswell is a CT2 (Anaesthetics) and Sandhya Lamichhane is a trauma coordinator. All are based at Queen Elizabeth Hospital, Woolwich, part of the Lewisham and Greenwich NHS Trust. The audit was conducted between April and July 2014.