Sip, don't skip: implementing 1-hour fasting in paediatric anaesthesia.

Area of Science:

• Anesthesiology
• Pediatric Care

Background:

• International guidelines support 1-hour clear liquid fasting for pediatric patients.
• Evidence, including systematic reviews and EUROFAST, confirms the safety of this practice.

Purpose of the Study:

• To highlight the discrepancy between established guidelines for pediatric 1-hour clear liquid fasting and current clinical practice.
• To emphasize the need for improved systems and quality initiatives to ensure adherence to fasting protocols.

Main Methods:

• Systematic review of existing literature.
• Analysis of the EUROFAST study findings.

Main Results:

• Strong evidence supports the safety and efficacy of 1-hour clear liquid fasting in children.
• Clinical practice demonstrates inconsistency in encouraging clear liquids and communicating fasting guidelines.
• A significant evidence-practice gap exists regarding routine implementation.

Conclusions:

• Despite robust evidence, the adoption of 1-hour clear liquid fasting for pediatric anesthesia remains suboptimal.
• There is a critical need for implementing practical systems and quality improvement measures.
• Ensuring 1-hour clear liquid fasting becomes standard care for children requires addressing communication and system-level barriers.