title: Pediatric fasting times before surgical and radiologic procedures: benchmarking institutional practices against national standards.
abstract: Prolonged preoperative fasting can be associated with adverse outcomes, particularly in children. Our aims were to assess the time pediatric patients fasted prior to surgical or radiologic procedures and evaluate whether fasting (NPO) orders complied with national guidelines. We measured NPO start time, time of last intake, and time test or surgery was scheduled, took place, or was cancelled in 219 pediatric patients. Findings demonstrate that pediatric patients experienced prolonged fasting before procedures and that the majority of NPO orders were non-compliant with national guidelines. We have developed strategies to reduce fasting times and ensure compliance with recommended national fasting standards.
authors.affiliation: Children's National Medical Center, Washington, DC. Electronic address: ciwillia@cnmc.org.
authors.forename: Catherine
authors.initials: C
authors.lastname: Williams
authors.affiliation: Children's National Medical Center, Washington, DC.
authors.forename: Pat A
authors.initials: PA
authors.lastname: Johnson
authors.affiliation: Children's National Medical Center, Washington, DC; School of Medicine and Health Sciences, George Washington University, Washington, DC.
authors.forename: Cathie E
authors.initials: CE
authors.lastname: Guzzetta
authors.affiliation: Children's National Medical Center, Washington, DC; George Washington University, Washington, DC.
authors.forename: Philip C
authors.initials: PC
authors.lastname: Guzzetta
authors.affiliation: School of Medicine and Health Sciences, George Washington University, Washington, DC; Department of Anesthesiology and Pain Medicine, Children's National Medical Center, Washington, DC.
authors.forename: Ira Todd
authors.initials: IT
authors.lastname: Cohen
authors.affiliation: Division of Biostatistics and Study Methodology, Center for Translational Science, Children's National Medical Center, Washington, DC.
authors.forename: Anne M
authors.initials: AM
authors.lastname: Sill
authors.affiliation: Children's National Medical Center, Washington, DC; School of Medicine and Health Sciences, George Washington University, Washington, DC.
authors.forename: Gilbert
authors.initials: G
authors.lastname: Vezina
authors.affiliation: Children's National Medical Center, Washington, DC.
authors.forename: Sherry
authors.initials: S
authors.lastname: Cain
authors.affiliation: Children's National Medical Center, Washington, DC.
authors.forename: Christine
authors.initials: C
authors.lastname: Harris
authors.affiliation: Children's National Medical Center, Washington, DC.
authors.forename: Jodi
authors.initials: J
authors.lastname: Murray
mesh_terms: D019985:Benchmarking; D002648:Child; D002675:Child, Preschool; D004219:District of Columbia; D005215:Fasting; D005260:Female; D019983:Guideline Adherence; D006760:Hospitalization / Q000706:statistics & numerical data; D006776:Hospitals, Pediatric; D006801:Humans; D007223:Infant; D008297:Male; D010372:Pediatrics / Q000379:methods; D017410:Practice Guidelines as Topic; D011300:Preoperative Care / Q000379:methods; D015641:Radiography, Interventional; D012016:Reference Values; D018570:Risk Assessment; D013514:Surgical Procedures, Operative; D013997:Time Factors
keywords: Compliance with ASA preoperative fasting guidelines; Fasting before sedated radiological procedures; Pediatric fasting time orders; Pediatric preoperative fasting