Fasting

Fasting before a procedure may reduce the risk of pulmonary aspiration. Patients undergoing an elective procedure should not consume solids or particulate liquids (eg tea with milk) in the 6 hours before a procedure, but can have clear liquids (eg water, clear apple juice) until 2 hours before the procedure. If fasting is not possible (eg in emergency cases), the risk of pulmonary aspiration must be managed appropriately. It is also necessary to manage the risk of pulmonary aspiration if the patient is expected to have delayed gastric emptying (eg after opioid administration, severe pain before arrival to hospital) or the procedure is associated with a high risk of pulmonary aspiration (eg upper gastrointestinal endoscopy).