Pediatric fasting times before surgical and radiologic procedures: benchmarking institutional practices against

Catherine Williams1, Pat A Johnson1, Cathie E Guzzetta2

  • 1Children's National Medical Center, Washington, DC.

Insights

Pediatric patients often fast longer than recommended before procedures, with most orders not meeting national guidelines. Strategies are being implemented to shorten fasting times and improve guideline compliance for children undergoing surgery.

Area of Science:

  • Pediatric Surgery
  • Anesthesiology
  • Clinical Nutrition

Background:

  • Prolonged preoperative fasting in children is linked to adverse outcomes.
  • Current fasting practices may not align with established clinical guidelines.
  • Ensuring appropriate fasting durations is critical for pediatric patient safety.

Purpose of the Study:

  • To evaluate the duration of preoperative fasting in pediatric patients.
  • To assess compliance of NPO (nothing by mouth) orders with national guidelines.
  • To identify areas for improvement in pediatric fasting protocols.

Main Methods:

  • Prospective measurement of NPO start time and last oral intake time.
  • Recording of scheduled, actual, or cancelled procedure times for 219 pediatric patients.
  • Comparison of observed fasting durations against national pediatric fasting guidelines.

Main Results:

  • Pediatric patients frequently experienced prolonged preoperative fasting periods.
  • A significant majority of NPO orders did not comply with national fasting recommendations.
  • Variability in fasting times was observed across different procedures and patient groups.

Conclusions:

  • Current preoperative fasting practices for pediatric patients are often excessive and non-compliant.
  • There is a critical need for adherence to national guidelines to optimize pediatric fasting protocols.
  • Implementation of targeted strategies can effectively reduce fasting durations and enhance patient safety.

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