Based on ASA preoperative fasting guidelines and the Guidelines on Preoperative Fasting by the Chapter of Anaesthesiologists, Academy of Medicine, Malaysia, I have drafted a handout that the surgeons are to distribute to all patients scheduled for elective surgeries. Please note that patients with conditions that may delay gastric emptying or who may present difficulties in airway management will require further attention that may alter the advice given in the handout. The handout may be used in procedures requiring general anesthesia, regional anesthesia, or sedation/analgesia (i.e., monitored anesthesia care). It was also unanimously decided that the form would also be used for pregnant ladies.
I have separated the advice into that for adults and that for paediatric patients based on the assumption that adults are better able to tolerate a prolonged fast than paediatric patients are. This will afford us greater flexibility when we need to make changes to the list e.g. when a case is cancelled or when the order of the list is rearranged.
Dr. Radha submitted our proposal to Dr. Charles V. David, the OT Subcommittee Chairman in a letter date 26 January 2000. As no action seemed to be forthcoming from Dr. David, I sent him a reminder dated 21 April 2000. I also reminded him verbally when I met him sometime in mid-May 2000. He promised to bring it up at the next OT Subcommittee meeting.
Copies of handout were given to Dr. Dalina and Ms. Loke to translate them into Bahasa Malaysia, and Tamil & Mandarin, respectively.
Instructions for staff to help in use of handouts produced and given to Phyllis (Day-Care Surgery) to try out.
Instructions were also given to Ms. Loke on the following day. Ms. Loke passed these (fasting handouts and instruction sheets) to Ms. Irene Quah.
Handouts said to be too complicated by OT Subcommittee. New (third) version with handouts for adults and paediatrics separated out into two separate sheets handed over to Ms. Loke who said that she will submit them to the OT Subcommittee. Datuk Dr. Radha also received a copy on 05 November 2000, with a note to submit them to the OT Subcommittee.
Sent reminders to Dato' Dr. Charles David, Datuk Dr. Radha, Ms. Loke and Ms. Wong. Dr. Ngun was then informed that at the OT Subcommittee meeting held on 02 April 2001, the handouts (version 3) had been approved (again) ... finally.
Ms. Quah requested that copies be given to her so that she could produce the handouts for distribution. Dr. Ngun supplied her with two copies on 04 April 2001.
20 June 2001
It was reported at the MAB that the Fasting Handouts have now been implemented and have been distributed to the relevant areas of the hospital. However, the handouts for the adults and paediatric patients have been combined onto a single page as proposed in the 2nd version of the handout.
This is a scanned image of the final version of the handout. If you compare this with the older version 2 of the handout, you will find that they are one and the same. Version 2 was created on 24 August 2000 based on feedback from the OT Subcommittee that having 2 pages for the handout was too unwieldy. It took the committee 10 months to finally decide to go back to that version.
Ah, well! Better late than never.
