Preparing Your Patients for Surgery with the ClearFast Enhanced Recovery Drink: Your Top 5 Questions Answered
With traditional NPO on its way out and pre-surgery carbohydrate loading taking its place, we’re now on the forefront of a major shift in the way the medical industry looks at surgery prep. This shift means that our team often gets asked a number of great questions about safely preparing patients for surgery with our enhanced recovery drink. We understand that, as medical professionals, your number-one goal is to ensure safe and effective surgical outcomes and overall patient satisfaction—which is why, today, we wanted to take some time to answer the top five questions we hear from physicians and healthcare centers. Read on for answers to our most common medical-pro FAQs.
1. We’ve always done NPO. Why should I be ClearFasting my patients now?
More and more medical research is pointing to the fact that pre-op carbohydrate loading with a clear, complex carb-rich beverage leads to safer procedures and greater patient satisfaction. There are a number of science-backed reasons you should consider replacing NPO with fasting with an enhanced recovery drink instead, including:
- Fluid Fasting Leads to Lower Stomach Acidity: The purpose of NPO is ultimately to reduce a patient’s risk of aspiration. Recent medical studies have found, however, that fluid fasting in place of NPO works to raise the pH in a patient’s stomach, leading to lower gastric acids and, ultimately, a reduced risk of aspiration under anesthesia. (You can read more about lowering stomach acidity and increasing patient safety with fluid fasting here.)
- Evidence-Based vs Non-Evidence Based: It’s important to keep in mind that NPO was never an evidence-based practice. Enhanced Recovery After Surgery Programs (ERAS®), evidence-based programs borrowed from Europe and the UK, are becoming increasingly popular in luminary hospitals across the United States. These programs are comprised of 17 key elements for perioperative patient management, which, when combined, work to ensure a better surgical outcomes, enhanced recovery after surgery and increased patient satisfaction overall. One of the most important of the 17 elements is preoperative carbohydrate loading using a compliant ERAS® drink like ClearFast in place of NPO. (You can read more about choosing the right ERAS® drink for better surgical outcomes here.)
- Higher Patient Satisfaction, Reduced PONV, Shorter Hospital Stays: In a large controlled study, patients in the pre-op area who drank ClearFast were 5.5-6.5 times more likely to describe themselves as “comfortable” than their cohorts who underwent traditional fasting from midnight. In addition to creating a more comfortable pre-surgery experience for patients, fluid fasting with the ClearFast enhanced recovery drink reduces a patient’s risk of PONV, ultimately decreasing the length of hospital stay.
2. Can my diabetic patients have ClearFast?
Any medical pro knows that preparing a diabetic for surgery is far more nuanced than preparing a healthy patient for surgery. Pre-op carb-loading for diabetics is actually one of the safest, most effective ways to manage blood sugar levels before, during and after surgery—which results in a number of benefits, including:
- It reduces a diabetic patient’s risk of pre-op complications: Diabetic patients are often the most adversely affected by prolonged fasting, as a prolonged fast can ultimately send their body into a catabolic state—which, for a diabetic, can lead to serious complications like hyperglycemia and even ketoacidosis. Rather than ignoring a diabetic’s unique dietary needs as traditional NPO does, a fluid fast with the ClearFast enhanced recovery drink works with a diabetic’s dietary needs, ultimately protecting their critical glycogen stores.
- It reduces a diabetic patient’s risk of postoperative insulin resistance (PIR): Numerous studies have found that pre-op carb-loading with a complex carb-rich, clear preop drink like ClearFast can reduce a diabetic’s risk of post-op insulin resistance and post-op infections, as well as reduce the occurrence of PONV—all of which make managing blood-sugar difficult, posing particular danger for those with diabetes. (You can read more about preparing your diabetic patients for surgery with ClearFast here.)
3. What about patients with gastroparesis or GERD?
We typically recommend patients finish their last bottle of ClearFast two hours prior to their surgery time; however we’ve modified these recommendations for those with delayed gastric emptying so as to avoid the risk of aspiration. Instead of a final dose completed two hours before surgery, we recommend you push the final dose to four hours before surgery. Again, as a physician, you always have the best, most informed guidance for your individual patient’s gastric emptying times.
4. Can my pediatric patients use the ClearFast enhanced recovery drink?
Absolutely! Pediatric patients are often the hardest to fast, which is why ClearFast is such a great option to keep them happy, hydrated and nourished before surgery. A pediatric patient’s dosing, of course, will differ from that of an adult’s depending on their weight and age. Take a look at our ClearFast Pediatric Dosing Chart for specific dosage recommendations to determine the best way to prep your pediatric patients for surgery with the ClearFast enhanced recovery drink.
5. You talk a lot about infection rates. How can ClearFast help with that?
NPO induces a catabolic state wherein the normal relationship between insulin and glucose are uncoupled. To compensate for the lack of “fuel” brought on by fasting, the body uses up its critical glycogen stores and then begins to breakdown fat and muscle as alternative energy sources. Insulin levels rise in response to rising glucose levels, but target cells (including muscle) fail to respond to it. In effect, patients become insulin-resistant. When patients are insulin-resistant after surgery and have a fresh surgical incision, the chance for infection greatly increases, as the “sweet environment” invites microbial colonization. Fluid fasting with the ClearFast enhanced recovery drink, on the other hand, effectively protects or spares critical glycogen stores in the immediate pre-op window and stabilizes blood sugars—reducing a patient’s risk of hyperglycemia and any associated infection. Ultimately, by reducing a patient’s risk of postoperative insulin resistance or PIR, ClearFast helps to reduce the risk of surgical infection.
Have we answered all of your questions? We hope so! If you’re ready to improve outcomes for your patients and your hospital, you can order your ClearFast Preop Drink here. Or, reach out to the ClearFast team at firstname.lastname@example.org if you have any questions at all. We’re always here and happy to help!