Bowel Preparation

Fasting guidelines is applicable to all client requiring anesthesia for all

surgical and non-surgical procedures like endoscopic (gastroscopy and
colonoscopy) and radiologic studies.
1. Check patients file and the procedure to be done. Ensure doctors
order.
2. Check patient identity using the ID band or letting the patient state
his or her name.
3. Explain the purpose of fasting or any mechanical bowel preparation
to be done.
4. Fasting before the procedure: ELECTIVE Surgeries
a. GENERAL ANESTHESIA:
Clear Fluid
Minimum fast for clear fluids (water, diluting juice, tea and
black coffee. Note the milk is not included) should be 2
hours prior to surgery.
Non clear fluids (pulp containing juice) should be avoided 6
hours prior to surgery.
Breast feeding infant should be fed 4 hours prior to surgery
Solid Food
Solid and milk containing foods should be avoided 6 hours
prior to surgery
Patients should eat normally on the day before surgery and
avoid large or fatty meals. Fat and dietary fiber tends to
remain in the stomach for longer than other foods.
Patients for a morning list should eat nothing for six hours
before surgery. Realistically, most patients will not usually
eat after midnight and this is a convenient cut-off point.
Children often do not eat after 6pm and a light snack at
bedtime should be advised.
Patients for an afternoon list should have a light breakfast
at least 6 hours prior to the start of the list. Patients with
diabetes mellitus should observe usual dietary guidelines
prior to fasting.
Notes:
Pre-medications can be given 2 hours prior to surgery with
minimal water (<30 ml)
Analgesics should never be omitted.
b. REGIONAL ANESTHESIA
Follow guideline for general anesthesia. There is likelihood
that this will be converted to GA.
c. LOCAL ANESTHESIA
No fasting required patients should eat a normal diet

d. INTRAVENOUS SEDATION
Fasting is requires.
5. Fasting in EMERGENCY surgeries
Check with anesthesiologist for further steps to be carried
out.
If possible to delay the surgery, follow the fasting
guidelines
Prolong period without fluids should be avoided.
Maintenance fluid containing glucose should be started for
patient not receiving fluids for more than 6 hours.
6. Mechanical bower preparation in case of colorectal surgeries
a. Administration of enema/fleet
Verify doctors order
Prepare all the equipment you need
Check clients identity then explain the procedure and the
purpose. Ensure privacy is protected at all times.
Perform hand washing and done clean gloving
Position the client to left side lying and administer the
medications.
Instruct client to remain in positing until the urge to defecate
starts. Assist the client to the toilet.
Perform post-procedure care.
b. Oral solution for bowel preparations.
Verify doctors orders.
Prepare the solution. E.g. Fortran + 1 L of water.
Verify identification. Explain the bowel preparation.
Give instructions on when to take, intervals and the amount of
solution to be taken. Give the client an idea on what to expect
after taking the medications.