Providers' fasting guidelines for adults

Fasting guidelines apply to patients 19 years and older receiving anesthesia from the Department of Anesthesia, including general, regional, monitored anesthesia care, and procedural sedation. The purpose of these guidelines is:

  1. to reduce the risk of pulmonary aspiration for patients receiving anesthesia services;
  2. to assist health care providers and patients in decisions about fasting intervals;
  3. to be consistent with accepted standards of clinical care and evidence-based practice.

Guidelines may need to be modified by the anesthesia provider for patients with co-existing conditions (difficult airway) or conditions that might affect stomach emptying or fluid volume, such as diabetes, hiatal hernia, gastro-esophageal reflux disease (GERD), ileus or bowel obstruction, and emergency care. Patients with these conditions are at greater risk of aspiration when airway reflexes are compromised by sedative medications and may alter anesthetic management.

Unless otherwise instructed, before elective procedures, the minimum duration of fasting should be:

• Two hours after clear fluids* 
• Six hours after non-clear fluids 
• Eight hours after enteral feeds or a meal containing fried foods, fatty foods, or meat 

* Clear fluids are limited to water, apple juice, black coffee or tea (NO milk, cream or creamer), Gatorade®, infant electrolyte solutions (Pedialyte®) and carbonated beverages (Coke®, 7-Up®).

Clear fluids should be utilized to take prescribed medications prior to the procedure. Crushed medications may be administered with up to 2 tablespoons of plain apple jelly.

These fluids should not include alcohol.

Noncompliance may result in delay or cancelation of the procedure. When these fasting guidelines are not followed, consideration of the amount and type of contents ingested along with the risks and benefits of proceeding must be weighed.

Questions? Call the Anesthesia desk at 319-356-2724.

Adapted and liberally paraphrased from practice guidelines by the American Society of Anesthesiologists (© 2017) and the European Society of Anesthesiology (© 2011)

Last reviewed: 
June 2017

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