Parents' understanding of and compliance with fasting instruction for pediatric day case surgery.
OBJECTIVE
To determine whether parents understand and adhere to preoperative fasting instructions.


OBJECTIVE
To identify how we may reduce perioperative morbidity relating to failure to fast.


BACKGROUND
Children are routinely fasted preoperatively with the aim of reducing the risk of aspiration of gastric contents and its sequelae.


METHODS
Parents of children on the day case ward following elective surgery completed a survey asking: (i) For how long was your child asked to fast? (ii) How long did you ensure your child was fasted of food and clear fluids? (iii) What do you think is the purpose of fasting? We also asked the parents to complete a checklist of items they thought acceptable to consume when fasting.


RESULTS
Despite affirming fasting status in the preoperative check, 13.5% were not fasted. Parents reported advised fasting times of 1-24 h (median 6) for solids and 0.5-24 h (median 3) for fluids. Children were fasted of solids for 3-40 h (median 9.5) and of fluids for 0.5-24 h (median 5). Regarding the understanding of fasting, 9 referred to aspiration and 53 to the prevention of nausea or vomiting. Thirteen believed that fasting status altered the efficacy of anesthesia. During the fasting period, 4.9% would allow French fries, 22.3% toast/crackers, 17.5% cereal, 14.7% a sweet, 14.9% gum, and 12.6% tea with milk.


CONCLUSIONS
Children we believe to be fasted may not be. Parents may deliberately misrepresent the actual fasting status of their child. Adherence to fasting advice may be affected by parents' recall and understanding of fasting advice.
Bristol Royal Hospital for Children, University Hospitals Bristol NHS Foundation Trust, Bristol, UK. cantellow@mac.com
Steve
S
Cantellow
Jonathan
J
Lightfoot
Helen
H
Bould
Richard
R
Beringer
D000293:Adolescent; D000556:Ambulatory Surgical Procedures / Q000379:methods*; D000768:Anesthesia, General; D002648:Child; D002675:Child, Preschool; D003142:Communication; D005215:Fasting; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007223:Infant; D008297:Male; D010290:Parents; D010349:Patient Compliance; D010353:Patient Education as Topic; D063466:Respiratory Aspiration of Gastric Contents / Q000517:prevention & control; D011795:Surveys and Questionnaires