1. Pre-op fasting audit: RAH and VOL Victoria Fraser

2. Outline Fasting guidelines RAH audit 2011-2012 VOL audit 2012 What action have we taken?

3. GGC Fasting guidelines am listpm list Solids including milky drinks and sweets Fast from 0230 (6 hours) Fast from 0730 (6 hours) Tea/coffee with max 2tsp milk Allow until 0430 (4 hours) Allow until 0930 (4 hours) Clear fluids Allow until 0630 (2 hours) Allow until 1130 (2 hours) Chewing gum is acceptable up to 2 hours pre-op but must not be swallowed Consider commencing IV fluids on any patient who is fasted for a prolonged period (greater than 12 hours)

4. RAH audit 2011-2012 100 patients interviewed in theatre reception Mean fasting time for solids was 15 hours 7 minutes Mean fasting time for liquids was 13 hours 54 minutes 95% of patients did not have IV fluids

5. RAH audit 2011-2012

6. VOL audit 2012 86 patients interviewed Mean fasting time for solids was 13 hours 4 minutes Mean fasting time for liquids was 12 hours 13 minutes 77% had IV fluids

7. VOL audit 2012

8. Differences between patient populations RAH and VOL VOL predominantly orthopaedics, RAH more a mix of specialties

9. What instructions did patients remember? RAHVOL

10. Conclusions Our instructions to ‘fast from midnight’ result in unnecessarily prolonged fasting times which may be detrimental to patients

11. What action have we taken? Educating staff about GGC guidelines New guidance for ward encouraging 300mls water at 0600 for am list and 1100 for pm list Alteration to preassessment instructions and new patient information leaflet In the process of re-auditing at RAH

12. Questions?