Key priorities for implementation

Quick reference guide

You can find a handy summary of the key recommendations of the guideline on our quick reference guide. You can use this to promote the recommendations by using it as a poster, handout or background wallpaper on your computer monitor.

You can also download the Quick Reference Poster (PDF 387.65KB) [see how to access PDF files].

Summary of recommendations

The following recommendations have been identified as priorities for implementation. Separate recommendations are given for adults and children for convenience.

Adults

Preoperative fasting in adults undergoing elective surgery - 'the 2 and 6 rule'

  • '2' - Intake of water up to two hours before induction of anaesthesia
  • '6' - A minimum preoperative fasting time of six hours for food  (solids, milk and milk-containing drinks)
  • The anaesthetic team should consider further interventions for patients at higher risk of regurgitation and aspiration.

Postoperative resumption of oral intake in healthy adults

  • Patients should be encouraged to drink when ready, providing there are no contra-indications.

Children

Preoperative fasting in children undergoing elective surgery - 'the 2-4-6 rule'

  • '2' - Intake of water and other clear fluid up to two hours before induction of anaesthesia
  • '4' - Breast milk up to four hours before
  • '6' - Formula milk, cows' milk or solids up to six hours before
  • The anaesthetic team should consider further interventions for children at higher risk of regurgitation and aspiration.

Postoperative resumption of oral intake in healthy children

  • Oral fluids can be offered to healthy children when they are fully awake following anaesthesia, providing there are no contra-indications
  • There is no requirement to drink as part of the discharge criteria.