Why eating before surgery can be a life or death issue

I was in the hospital for sepsis and the patent in the next room was going in for a bilateral leg amputation due to diabetes, his friends came in about 30 minutes before his surgery and they all did shots together for about 10 minutes before the nurse saw what was going on . I have never seen a more angry nurse in my life . The surgery was cancelled for that day also .

Reminds me of the story of a lady checking in at surgery with her 10 year old son. Nurse asks if he has eaten anything in the last 8-10 hours. She says no, while the kid is eating a bag of Doritos. She gets mad when the surgeon cancels surgery.

"She was fussing because she was thirsty, so I gave her a little juice. I didn't think it was a big deal " the dad said to the surgeon, after his daughter almost died from aspirating fluid into her lungs while under anesthetic.

Several years ago I was going to have surgery and was told no food or drink, not anything, not even water. They made a point of that, repeating it 5 times. But when it came time to get my surgery, my blood pressure was high because I didn't take my blood pressure meds. They were all mad at me for not taking my meds. I pointed out that they made it absolutely 100% clear that I was absolutely not to eat or drink anything, not even water, so I didn't take my medicine. They all acted as if I was stupid for following their instructions to the letter and told me, "well, you can drink a little water to take your medication". They should have told me that before. How do you think I felt? I fasted for nothing. I was the one who was hungry, thirsty and had to reschedule and fast all over again.

I remember hearing a story about a dad who had to bring his young daughter in for surgery, he felt that the "no eating or drinking" rule was too strict so he let her have breakfast, she later died of pulmonary aspiration during surgery and that has scared me into listening to my doctor very closely

As somebody who spent nearly six weeks in the hospital with aspiration pneumonia and a related lung abscess after I aspirated my stomach contents during knee surgery, I can attest that this is a serious and pressing concern.

Trying to explain this to my cats before they have a dental cleaning under anesthesia is always an issue. We have to go around the house the night before and make sure that all the water bowls are taken up and all the toilets are closed. It's especially a point of argument if only one is going under anesthesia and the other has to whine and go hungry all day.

In outpatient surgery, we have many patients lie about not eating or drinking. Then we find out when we extubate , they aspirate , then we have to call an ambulance to transfer them to the hospital on a ventilator. Or they lie, and feel the pressure right before surgery and say, well, I did eat a jelly bean….but usually it’s much more than they admit to. I really wish the pre op instructions would tell patients this is actually a matter of life or death that they don’t eat and drink. I think they just tell them to not eat or drink but never say why

I was wondering how anesthesia was handled with emergencies, such as appendectomies, where the patient hasn’t had time to fast before the surgery. Thanks for posting.

I had an emergency appendectomy when I was 18, in 1980. A couple of hours before my symptoms became bad enough that we headed to the hospital, my mom got me to try eating a light lunch to see if it helped. The first thing I heard when I woke up in recovery was two orderlies speculating about whether it was half-digested chicken soup or chicken salad they had just cleaned up. I signaled my return to consciousness by croaking "Soup". 🙂

A friend of my dad's has a story related to this. He was set to do surgery on a little girl, about 7 or 8, and instructed her parents not to let her eat anything from the night before the procedure. While on the operating table, she started vomiting, and went into cardiac arrest. It turned out that, since the little girl had been complaining that she was hungry, her parents had decided some eggs for breakfast would surely be fine... right? In the end, they managed to bring the girl back, but that story has always stuck with me.

I think it's odd that people don't listen when they're told not to eat or drink anything before surgery. Why wouldn't you listen? They tell you that for a reason, even if you don't understand why.

I have type1 diabetes and recently had a short surgery under general anaesthesia. While I was waiting before surgery my blood glucose was falling gradually and eventually I could see I was going to have to do something about it. Normally I'd just eat something but obviously that was out. I let the nurses know about the situation, thinking it was all going to be pretty simple, since to me this is a completely normal kind of situation and I knew exactly what needed to be done. But I forgot that's not how things work in a hospital. Any time someone has Type 1 diabetes everyone seems to completely panic because it's just something they only have to deal with rarely. I know they just needed to give me some IV glucose but the nurses have to go and find a doctor to make the decisions. The doctor turns up, starts asking me questions about what symptoms I'm experiencing due to low blood glucose, I have no idea why! She decided they were going to start sliding scale treatment (IV glucose and insulin) which is used when a patient can't manage their own diabetes for whatever reason. This was about a 2 hour surgery so definitely not required in this case. Anyway, the hospital had just got a new computer system so the nurses were trying to work out how to log the medications on the system, and whether to start the insulin or glucose first. When I heard that, I couldn't quite believe it! At this point I've been hypoglycaemic for an hour, getting worse and worse, and now I'm hearing they're going to start giving me insulin?! I'm normally a pretty chill person, but if you've ever experienced being "hangry" you can probably understand my getting a bit more assertive sitting there with a blood glucose of 2.5 (45 in american units) Doctor was long gone by that point so I just told them to start the glucose now and we can talk about the insulin when I'm not about to expire, which they did. Half an hour later I'm feeling much better, apologised for being short with them, and with my brain working again I was able to explain that I didn't need any insulin and the problem was sorted now. But what a rigmarole! honestly if they hadn't been watching me the whole time I think I would have just eaten 20g glucose and sipped a mouthful of water. I think really that would have been the best option too. The glucose would have been completely absorbed, leaving nothing in the stomach. But I appreciate there are procedures that are designed to cover the majority of situations and be simple enough not to leave open the possibility of confusion. Having Type 1 in a hospital situation is a nightmare because you're used to dealing with this complex condition all by yourself, and become an expert. But then you go into a hospital and suddenly somebody else is in charge of it all, and they don't actually know what they're doing. If you have type 1 and you're going into hospital for any amount of time, I recommend insisting on seeing the diabetes specialist so you can have a conversation with them, work out how the condition is going to be managed, and then they can advocate for you with the medical staff.

We had a patient come in for a tilt table test. I asked her when she ate last. Answer was, about two hours ago. What and how much did you eat? A plate of liver and onions with mashed potatoes and a coke. She got rescheduled! I had a chat with her about why it’s important to not eat prior to this test. There is a risk of aspiration should a patient lose consciousness. I have been in other situations where the patient says they’ve not ate but during a procedure the truth comes up….literally! All we have to go on is what the patient says.

My father had a quadruple bypass in 1990. He died from pna from aspirated stomach acid. Back then they didn’t have the cuff on the endotracheal tube, so it just flowed up. Ironically, his heart was fabulous, sepsis killed him😢

Thanks for the information. I'll start taking those no food or drink orders more seriously from now on. I've had quite a number of surgeries for a number of different medical issues. Usually I do refrain from eating well in advance, but I do occasionally sip some water before surgery. I always thought that no food or drink order was to prevent nausea. Never realized it was all about aspiration.

I had a really fun experience with anesthesia last month. I have a multitude of sleep disorders which always get the anesthesiologist’s interest. Anyway, I remember being taken to the OR, being given two syringes of stuff and being asked “are you getting tired yet?” I said no. Then we talked about Whitney Houston who was playing in the PR and how no one in the room seemed like the Whitney Houston type. Then another anesthesiologist showed up, told the original anesthesiologist to skip to the fourth syringe while he drew up some other stuff. Finally I was out. I was quite the topic of discussion in the PACU. Fun times. 🤘🏻

I know that when you're going to surgery, you're forbidden to eat or drink anything, but i never know that it can life threatening. Thank you for your video. When i was going for surgery to remove a metal pin on my broken arm, my surgery starts at 4pm, i was fasting from 8/9am i think, and on 3pm i'm feeling really thirsty that makes me really want to drink a mineral water, my thoughts at that moment was "it won't matter too much right? because it's just a regular water", but then for some miracle i didn't take it and endure the thirsty feeling. Thank God my surgery was successful.

The funny/sad thing is healthcare workers can explain exactly why ignoring directions can lead to death but people will still ignore them thinking they’re the exception.

Thankyou for explaining! I am still baffled at people who don't take this seriously or feed their children before surgery. Like, we get it, its difficult to go hungry for 8 hours, especially for a cranky child who doesn't understand, but its only temporary and they will not die. When I was a teen, I was in the childrens surgery unit for day surgery and I was in a small cubicle waiting for anesthesiologist, another family was next door with parents and a 4 year old boy, the doctor asked them clearly, "has your son had anything to eat or drink in last 8 hours?", the father replies, "no, but 2 hours ago he had some toast and scrambled eggs"... the doctor went silent, um... genius man, scrambled eggs and toast is FOOD! In what world is toast and scrambled eggs not food?? The doctors cancelled their surgery, rightfully. It seems like many parents are okay with the serious risks than to hear their whiny brats cry and complain... anything to shut them up I guess.