Utilizing Gastric Point-of-Care Ultrasound Assessment for Patients with Questionable NPO Status

Author

Carolina BoteroFollow

Date of Award

Spring 5-5-2023

Document Type

DNP Project

Project Team Faculty Member

Dr. Beth McCoy MBA, CRNA, APRN

Project Team Faculty Member

Dr. Matthew Bednarchik DNP, CRNA, APRN

Keywords

point-of-care ultrasound, POCUS, pulmonary aspiration, gastric contents, airway management, NPO guidelines

Abstract

Perioperative aspiration is a rare but serious complication with high morbidity and mortality for patients. This event often occurs from anesthetic depression of protective airway reflexes. NPO guidelines are implemented before anesthesia to eliminate the presence of any gastric contents. However, patients with certain comorbidities may still persist with a full stomach before an anesthetic. Patients may complicate matters further by not following NPO instructions, the patient’s NPO status may be unknown, or the timing of surgery may prevent adequate NPO times. In these situations, the anesthesia provider is faced with the difficult decision to alter, delay or potentially cancel the anesthetic and therefore the surgical procedure. Gastric point-of-care ultrasound (POCUS) can be used to assess the status of the patient’s gastric contents to objectively decide how to manage an anesthetic. The difficulty in the implementation of this tool lies in the level of confidence and efficiency of the anesthesia provider’s assessment to dictate decision-making. This project’s goal was to train anesthesia providers to feel more confident in their ability to utilize this tool to mitigate relevant risks. Short knowledge tests and opinion surveys were administered before and after training on gastric POCUS. Anesthesia providers improved in their willingness and confidence to continue usage of gastric POCUS in appropriate scenarios. This will provide cost savings and improve safety within our facility which ultimately adds value in our clinical setting.

Recommended Citation

Botero, Carolina, "Utilizing Gastric Point-of-Care Ultrasound Assessment for Patients with Questionable NPO Status" (2023). Doctor of Nursing Practice Projects. 266.
https://spark.siue.edu/dnpprojects/266

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