Spine Research

Reducing the inappropriate use of nil by mouth in acute surgical admissions.

Reducing the inappropriate use of ‘nil by mouth’ in acute surgical admissions
Hoda Amar, Luke Bennett, Richard Galloway, Oliver Hald, Nicholas Baylem, Royal Bournemouth Hospital
Introduction: Patients are advised to remain ‘nil by mouth’ (NBM) prior to surgery to reduce the risk of aspiration peri-operatively, or when certain surgical pathologies require. Guidelines from The European Society of Anaesthesiology state that patients are permitted food up to 6 hours and clear fluids up to 2 hours prior to surgery1. Patients are often asked to fast unnecessarily resulting in dehydration and discomfort.
Methodology: The NBM status of 50 admissions to the Surgical Assessment Unit (SAU) were evaluated during a one-week period. A decision was made as to whether this was appropriate according to the guidelines above and peer review. An intervention was designed to raise awareness of the use of ‘nil by mouth’. A poster demonstrating the study results and a flowchart to aid decision-making according to the likelihood of needing a scan and/or emergency surgery were displayed in SAU. After two weeks a re-audit was performed.

Author(s): Azhar Ali

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