Risk Management in the Ordering and Confirmation of Fasting before Surgery in Nagasaki University Hospital

Abstract

  We standardized the way to order that a patient fast before surgery in our hospital in 2003. However, there were cases in which the order to fast wasn't adhered to, so we standardized the way of confirming that the patient fasts, too. After implementing these standardizations, we had a patient who vomited during the induction of anesthesia and developed aspiration pneumonia, although he fasted sufficiently before the surgery. The patient was a boy with inguinal hernia. The operation was canceled and he was transferred to the intensive care unit, where he recovered without any complications. We explained to his family his status, treatment plan, and possible complications, and we also explained that the ordering and confirmation of fasting was most certainly done. The quick treatment and honest explanation after the accident enabled us to avoid trouble with the patient's family. It is very important to standardize the way of ordering and confirming of necessary procedures like fasting before surgery.