Fasting Guidelines
Adapted from American Society of Anesthesia 2011 Fasting Guideline & 2017 CAS Guidelines to practice of anesthesia Full guidelines here:
Preoperative Fasting Status
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Adults:
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Clear Fluids: 2 hrs
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Light meal & Non-human mild: 6 hrs
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Fried fatty meal/meat: 8 hrs
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Pediatrics:
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Breast milk: 4 hrs
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Formula: 6 hrs
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Pharmacologic Therapy
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Gastrointestinal Stimulants
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DO NOT USE ROUTINELY if average risk of reflux/aspiration
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Maxeran
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good evidence for gastric emptying
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no good evidence for reducing acidity
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Gastric Acid Reducing Agents
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DO NOT USE ROUTINELY if average risk of reflux/aspiration
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All H2 receptor antagonists (cimetidine, ranitidine, famotidine) effective for reducing gastric volume & acidity. Miller says Ranitidine most effective for reducing the gastric volume.
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PPI effective for reducing gastric volume & acidity
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Insufficient evidence to decide between H2-blocker VS PPI
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Antiemetics
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DO NOT reduce the risk of aspiration in otherwise normal patients
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Should NOT be routinely used
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Effective only for PONV
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Anticholinergics
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NOT recommended routinely
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Equivocal evidence that they reduce gastric volume or acidity
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