ArticleANZ journal of surgery
Use .FAST to Sip Til Send: A Quality Improvement Initiative Using Digital Solutions to Facilitate Best Practice Preoperative Fasting Protocols in Emergency General Surgery.
Article in ANZ journal of surgery. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Who cites it
2 citing papers in PubMed.
- True Preoperative Liquid Fasting in Romania-A Secondary Analysis of the Thirst Study.Nutrients · 2026Observational
- Beyond "Fast From Midnight"-The New Fasting Norm Is Here.ANZ journal of surgeryArticle
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Authors and funding
6 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundReduced preoperative fasting times are beneficial for patients, have negligible aspiration risk and minimise intravenous fluid (IVF) use. For over 15 years the national anaesthetic guidelines in Australia have recommended solid food until 6 h prior to surgery and unlimited clear fluids until 2 h prior to surgery. In 2024 an additional recommendation was added: sips of clear fluids (typically water) up to 200 mL/h until sent to theatres. Nonetheless, 'fast from midnight' (FFM) and 'nil by mouth' (NBM) are commonly used.
methodsThis study was conducted on patients in a single, tertiary, metropolitan hospital. Baseline preoperative fasting data were retrospectively collected from 21/08/2024 to 18/09/2024. A staff education campaign and an EMR smart phrase (".FAST") were then introduced. Post implementation data were prospectively collected from 28/10/2025 to 20/01/2025. Data were analysed for fasting protocol type, total fasting time (TFT), and preoperative IVF use. Data modelling was used to calculate the projected impact of the .FAST protocol.
resultsUptake of best practice fasting guidelines increased from 1% to 47% (p < 0.001). This was associated with a marked IVF use reduction-from 41% to 17% of patients (p < 0.001)-and a decrease in median fasting time from 9 to 2 h (p < 0.001). Median total time on IVF reduced from 8 to 0 h (p < 0.001). Projected annual savings in EGS with 100% uptake of the .FAST protocol were projected to be 23 doctor workdays and 46 nurse workdays (assuming an 8 h workday), and $2460 in IVF cost.
conclusionsImplementation of a simple to use, contemporary preoperative fasting protocol in EGS through staff education and an EMR smart phrase led to decreased time fasted for patients and IVF use. No patients fasted with .FAST had surgery cancelled due to inadequate fasting.
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