Post-it Sunday 11/6/22-NPO is not just a suggestion

The gown card reads ‘unauthorized water.’

I remember this, because it happens ALL the TIME.

NPO is not just a suggestion and up to the patient to follow or not follow.

I know it’s tough to have a long wait. Especially when you are thirsty.

I know.

Sometimes cases run over but when we ask re NPO, that means nothing per os, or nothing by mouth.


Not unauthorized water from an unknown source.

Although, as an aside, when you are thirsty and uninterested to going to get a glass of water from the kitchen, that water tastes the best. Like, ever.

We will know.

We always know.

Especially when your CRNA has to suck it from your lungs,

Because after you’ve been put under anesthesia, you are no longer able to protect your airway.

And what was in your stomach comes up.

It sucks. I know.

But it beats aspiration pneumonia.

Just imagine that you had a laryngeal mask airway (LMA) in which does not cut your lungs off from your stomach. We use these with people who are at low risk for aspiration. AND NPO for 8 hours.

Why? It is gentler on the throat and means that we can remove it sooner and still keep you asleep for your surgery.

If your stomach contents make a surprise visit after the LMA has been seated, the acid and contents can go into your lungs. Causing aspiration pneumonia. And a surprise intubation is no one’s idea of fun. The endotracheal tube has to stay in place until you are awake enough to protect your airway and protest the tube down your main bronchus.

Remember this next time you want to drink bathroom tap water because it has been SOOOOO long, and you’ve been thirsty for SOOOOO long.

Is it worth it?

Is it worth possibly dying?

I don’t think so.

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