912 Do You Really Know What “Nil by Mouth” Means?

Abstract

Abstract Aim To assess if patients are receiving their regular pre-operative medications in according with local and national guidance and to assess if patients are being appropriately fasted pre-operatively. Method A prospective study performed across a 2-week period, assessing if every patient booked on the emergency theatre list was receiving the correct medications pre-operatively and if they were fasted for the appropriate length of time. This involved assessment of the patient's notes and drug chart, as well as clarification of any unknowns with the patient. Results 65 patients met the inclusion criteria for the study; of which 28 (43%) had their regular medication prescribed. Of those, 61% did not receive their medications according to national and local guidance (medications were inappropriately held in the majority of cases). The omission of administering medication during the “nil by mouth” phase included the lack of critical medication in 3 cases: a potentially life-threatening error. Regarding fasting of the patient, it was found that the average time without drink was 14 hours 25 minutes, with the average time without food being even greater at 24 hours 12 minutes. Conclusions Patients are not receiving medications in the pre-operative fasting stage appropriately, this was mainly due to the incorrect assumption that “nil by mouth” is equivalent to no oral medications. In addition to this, the study found that patients are being kept without food or drink for far too long prior to surgery and hence reducing the quality of their pre-operative status both clinically and biochemically.