Chewing gum in the preoperative fasting period: an analysis of de-identified incidents reported to webAIRS

Shanmugam, S., Goulding, G., Gibbs, N. M., Taraporewalla, K. and Culwick, M. (2016) Chewing gum in the preoperative fasting period: an analysis of de-identified incidents reported to webAIRS. Anaesthesia and Intensive Care, 44 2: 282-285.

Author Shanmugam, S.
Goulding, G.
Gibbs, N. M.
Taraporewalla, K.
Culwick, M.
Title Chewing gum in the preoperative fasting period: an analysis of de-identified incidents reported to webAIRS
Journal name Anaesthesia and Intensive Care   Check publisher's open access policy
ISSN 1448-0271
0310-057X
Publication date 2016-03-01
Year available 2016
Sub-type Article (original research)
Open Access Status Not yet assessed
Volume 44
Issue 2
Start page 282
End page 285
Total pages 4
Place of publication North Sydney, NSW, Australia
Publisher Australian Society of Anaesthetists
Collection year 2017
Language eng
Abstract The role of preoperative fasting is well established in current anaesthetic practice with different guidelines for clear fluids and food. However, chewing gum may not be categorised as either food or drink by some patients, and may not always be specified in instructions given to patients about preoperative fasting. The aim of this paper was to review anaesthesia incidents involving gum chewing reported to webAIRS to obtain information on the risks, if any, of gum chewing during the preoperative fasting period. There were nine incidents involving chewing gum reported between late 2009 and early 2015. There were no adverse outcomes from the nine incidents other than postponement of surgery in three cases and cancellation in one. In particular, there were no reports of aspiration or airway obstruction. Nevertheless, there were five cases in which the gum was not detected preoperatively and was found in the patient's mouth either intraoperatively or postoperatively. These cases of undetected gum occurred despite patient and staff compliance with their current preoperative checklists. While the risk of increased gastric secretions related to chewing gum preoperatively are not known, the potential for airway obstruction if the gum is not detected and removed preoperatively is very real. We recommend that patients should be specifically advised to avoid gum chewing once fasting from clear fluids is commenced, and that a specific question regarding the presence of chewing gum should be added to all preoperative checklists.
Keyword Adverse outcome
Chewing gum
Hazard
Q-Index Code C1
Q-Index Status Provisional Code
Institutional Status UQ

Document type: Journal Article
Sub-type: Article (original research)
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