AB145. SOH26AB_0186. Introducing a novel fasting protocol in an elective orthopaedic hospital

Background: “Sip Til Send” is a novel fasting protocol introduced in Croom hospital, an elective orthopaedic hospital, allowing patients to drink water up until the time they are called for theatre. Traditional preoperative fasting guidelines typically recommend no fluid intake for 2 hours prior to surgery. However, patients often fast for considerably longer periods, leading to negative outcomes such as haemodynamic instability, increased pain scores, and acute kidney injury. Recent evidence suggests that strict fluid restriction may be unnecessary, and allowing patients to drink water until they are called for theatre can reduce fasting duration without increasing the risk of aspiration. We aimed to introduce a novel fasting protocol in an elective orthopaedic hospital.

Methods: Initial data on fasting times were collected to establish baseline fasting durations. Following protocol implementation, a re-audit assessed compliance and the effectiveness of the policy in reducing fasting times.

Results: In the pre-policy audit of 40 patients, the average fluid fasting time was 9 hours [standard deviation (SD), 3.9 hours; range, 2–16 hours]. Following implementation of “Sip Til Send”, 43 patients were audited, showing an average fluid fasting time of 0.5 hours with a range of 0.5–1 hour.

Conclusions: This audit demonstrated a substantial reduction in fasting duration for fluids following implementation of “Sip Til Send”. Shorter fasting periods are likely to improve patient comfort, reduce dehydration, and enhance perioperative outcomes. This audit supports wider adoption of evidence-based strategies to optimise preoperative fasting practices.

Keywords: Audit; fasting; fluids; preoperative; protocol