Is NPO after Midnight Archaic? Dr. Trivedi

Puja Trivedi, DO

Time to Abolish “NPO After Midnight” by Mark Singleton MD

Dr. Singleton highlights an archaic term, "NPO after midnight," which
was coined with patient safety at heart but in the modern day context
can actually harm our patients. In the past, patients were asked not
to eat or drink anything after midnight to ensure an empty stomach.
However. this led to both binge eating at 11:45pm (which may lead to a
bloated, uncomfortable, sleep deprived patient the morning of surgery)
or conversely, starvation due to case delays or cancellations. As
surgical care transitions from a solely in patient practice where all
surgical patients had been admitted in the past to more of an emphasis
on outpatient, ambulatory surgical centers, patients are scheduled and
asked to arrive at specifc times. For example, a patient scheduled for
an elective procedure at 3pm should be allowed to eat a light
breakfast. Unfortunately this is only one part of the battle. The
notion of NPO after midnight is often echoed by surgical team members,
pre op nursing and hospital staff. It is for this reason that Dr.
Singleton advocates the concept of having an anesthesiologist contact
the patient the night before to answer and address the issue of "NPO."