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Variation in preparation for gastroscopy: lessons towards safer and better outcomes

Variation in preparation for gastroscopy: lessons towards safer and better outcomes
Variation in preparation for gastroscopy: lessons towards safer and better outcomes
OBJECTIVE:

To identify the methods employed within the UK practice prior to diagnostic gastroscopy and compare with published guidelines for patients undergoing general anaesthesia.

DESIGN:

National Health Service (NHS) endoscopy units were invited to take part in a structured telephone survey to determine the length of time patients are kept nil-by-mouth (NBM) for food and fluids prior to gastroscopy, and whether a preprocedure mucolytic drink was used.

METHODS:

212 NHS Trusts providing endoscopy services were identified from the Joint Advisory Group on GI Endoscopy. Trusts were excluded if they were children's hospitals (n=5).

RESULTS:

207 NHS Trusts were telephoned. 193 completed the survey (93%), 11 Trusts declined and there was no response from 3 Trusts. 13 separate policies regarding NBM timings were identified. 51 Trusts (21%) used the timings ratified by Surgical and Anaesthetic Societies (6 h NBM for food, 2 h for clear fluid). 135 Trusts (70%) used a policy which starved patients in excess of the standard surgical guidelines. No Trust used a mucolytic drink prior to gastroscopy.

CONCLUSIONS:

The survey revealed large variation in NHS Trust's policies regarding the times patients were starved prior to gastroscopy. Results of surgical studies demonstrate increased risk of significant pulmonary aspiration with increased fluid-starvation periods, 68% of NHS endoscopy policy would be deemed excessive by surgical practice. There is no routine use of a mucolytic drink to improve mucosal visualisation in the UK practice.
2041-4137
187-190
Callaghan, J.L.
54a7726c-1a8f-4d96-b3ea-2062baa95d89
Neale, J.R.
97fea948-1718-4d47-a5e5-8ea7a3480308
Boger, P.C.
cfba8d36-6a76-476d-8df8-b6035b4cae9f
Sampson, A.P.
4ca76f6f-ff35-425d-a7e7-c2bd2ea2df60
Patel, P.
244cc88b-5b33-43f8-93d8-2656943ad0c4
Callaghan, J.L.
54a7726c-1a8f-4d96-b3ea-2062baa95d89
Neale, J.R.
97fea948-1718-4d47-a5e5-8ea7a3480308
Boger, P.C.
cfba8d36-6a76-476d-8df8-b6035b4cae9f
Sampson, A.P.
4ca76f6f-ff35-425d-a7e7-c2bd2ea2df60
Patel, P.
244cc88b-5b33-43f8-93d8-2656943ad0c4

Callaghan, J.L., Neale, J.R., Boger, P.C., Sampson, A.P. and Patel, P. (2016) Variation in preparation for gastroscopy: lessons towards safer and better outcomes. Frontline Gastroenterology, 7 (3), 187-190. (doi:10.1136/flgastro-2015-100647).

Record type: Article

Abstract

OBJECTIVE:

To identify the methods employed within the UK practice prior to diagnostic gastroscopy and compare with published guidelines for patients undergoing general anaesthesia.

DESIGN:

National Health Service (NHS) endoscopy units were invited to take part in a structured telephone survey to determine the length of time patients are kept nil-by-mouth (NBM) for food and fluids prior to gastroscopy, and whether a preprocedure mucolytic drink was used.

METHODS:

212 NHS Trusts providing endoscopy services were identified from the Joint Advisory Group on GI Endoscopy. Trusts were excluded if they were children's hospitals (n=5).

RESULTS:

207 NHS Trusts were telephoned. 193 completed the survey (93%), 11 Trusts declined and there was no response from 3 Trusts. 13 separate policies regarding NBM timings were identified. 51 Trusts (21%) used the timings ratified by Surgical and Anaesthetic Societies (6 h NBM for food, 2 h for clear fluid). 135 Trusts (70%) used a policy which starved patients in excess of the standard surgical guidelines. No Trust used a mucolytic drink prior to gastroscopy.

CONCLUSIONS:

The survey revealed large variation in NHS Trust's policies regarding the times patients were starved prior to gastroscopy. Results of surgical studies demonstrate increased risk of significant pulmonary aspiration with increased fluid-starvation periods, 68% of NHS endoscopy policy would be deemed excessive by surgical practice. There is no routine use of a mucolytic drink to improve mucosal visualisation in the UK practice.

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More information

e-pub ahead of print date: 8 March 2016
Published date: July 2016

Identifiers

Local EPrints ID: 416537
URI: https://eprints.soton.ac.uk/id/eprint/416537
ISSN: 2041-4137
PURE UUID: be61566e-138b-4ac9-bf2f-bea43eda0405

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Date deposited: 21 Dec 2017 17:30
Last modified: 18 Nov 2019 18:28

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Contributors

Author: J.L. Callaghan
Author: J.R. Neale
Author: P.C. Boger
Author: A.P. Sampson
Author: P. Patel

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