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Feeding - Pre-operative guideline for PICU patients going to the OR

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These guidelines apply to ALL enterally fed patients in PICU


Providing adequate nutrition is a vital part of intensive care. Many patients in PICU require recurrent trips to the OR often without a set time. This can result in unnecessary prolonged interruptions to their enteral nutrition.

This guideline aims to minimise interruptions to feeding in these patients. It has been discussed with and approved by the SS anaesthesia department. DO NOT deviate from these guidelines.

Intubated Patients

If these patients are absorbing their feeds AND they are NOT having a procedure that involves the airway OR changing the endotracheal tube then they can continue to be fed up until the time that they go to the OR. It does not matter if they are NG or NJ fed.

There may be some instances where these patients should be NPO pre-op. This will be communicated to PICU by the anaesthetic department. The default position is as above.

Non-intubated Patients

Patients who are NJ fed can have this continued up until the time they go to the OR.

ALL other non-intubated patients are NPO as per the SSH anaesthesia department guidelines. See below.

All Patients

Administer all usual medications as charted (IV and oral).

Starship Anaesthesia NPO Guidelines

  • 4 hours breast milk and infant formula.
  • 6 hours cows milk and food.
  • Clear fluids allowed up to 2 hours pre-op.

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Document Control

  • Date last published: 04 August 2014
  • Document type: Clinical Guideline
  • Services responsible: Paediatric Intensive Care Unit
  • Editor: John Beca
  • Review frequency: 2 years