...Preoperative fasting: Is it based on evidence? The rule ‘Nil by Mouth’ from midnight is used traditionally to ensure that the stomach is empty prior to induction of anaesthesia. It is clearly stated that during induction of anaesthesia, the protective laryngeal reflex is diminished, which maximises the risk of pulmonary aspiration. Even in the early days of the anaesthetic era, most people understood that prior to surgery, no intake of solid food was to be consumed. (Ljunggvist&Soreide, 2003) Ljungvvist&Soreide (2003) explains that surgical authorities recommended that patients have fluids containing carbohydrates, for example, beef tea, during the preoperative period. In spite of this, later studies revealed anaesthetic related aspiration. This resulted in progressively firmer rules for preoperative fasting, in which case patients were informed not to consume solids and liquids prior to sugery- ‘Nil by Mouth’ from midnight. (Ljunggvist&Soreide, 2003) Over the past two decades, authors have questioned the need for such intense fasting regimes. Following this, studies have been completed, which showed that guidelines which are less intense can be used to benefit the patient. (Ljunggvist&Soreide, 2003)Ljunggvist&soreide (2003) explain that following the studies, healthy adults who are undergoing surgery, can consume clear fluids up to two hours prior to surgery. However, this does not apply to people who have got gastrointestinal deficiencies or diabetes. This...
Words: 1647 - Pages: 7
...NM1704: Applying a model of nursing roper, logan and tierney model This essay explores the preoperative care provided to one patient in a London hospital during one shift. This care was influenced by the holistic perspective to health. Arsing from the Greek for ‘whole’ this acknowledges physiological, psychological and social factors impacting the patient’s condition. (McFerran & Martin, 2008) It seeks to offer treatment inclusive of these factors rather than treating physical symptoms of a diagnosed disease in isolation. This essay will examine this within a Model of Nursing used in my clinical placement area - the Roper, Logan and Tierney model. The identities of both hospital and patient have been altered to maintain confidentiality and comply with the NMC Code of Conduct. (Council, 2008) During my placement I worked on a coronary care unit where I cared for a patient herein called Peter, a 60 year old White British male. Peter was single, lived alone and unemployed. He had a history of low mood and was admitted to a neighbouring hospital suffering symptoms of acute alcohol withdrawal syndrome (acute confusion, delusions and tremors). This arises when an individual reduces or stops alcohol consumption after prolonged periods of excessive alcohol intake. This can lead to tolerance, physical dependence and physical disturbances upon withdrawal due to the central nervous system reacting in a hyper-excitable state. (About.com, 2010) He was transferred to my area...
Words: 3559 - Pages: 15