New pre-surgery liquid fasting protocol to enhance patient comfort
16 April 2025
Grampians Health has implemented a new fasting protocol called ‘Sip Til Send’ that reduces liquid fasting times before surgery or procedures that require general anaesthesia or sedation.
Patients preparing for surgery have historically stopped consuming solid food six hours and liquids two hours prior to their operation, remaining fasted until they reach the recovery area.
The Sip Til Send approach allows patients to slowly drink up to 200ml of clear liquids (defined as those that you can see through against the light) every hour until they are taken to surgery. The latest approach prioritises patient comfort and has the potential to reduce post-operative complications.
“The ‘Sip Til Send’ approach is a significant advancement in pre-operative care and we’re pleased to implement this in Grampians Health,” said Ben Kelly, Chief Operating Officer at Grampians Health.
“This initiative reflects our commitment to patient-centred care and also aligns with our goal of providing safe and effective healthcare solutions.”
Sip Til Send was introduced after an internal audit revealed that patients who were preparing for a surgery were fasting for longer than the required time. However, the findings were similar to other hospitals across Australia and worldwide, where many patients underwent prolonged fasting.
“Prior to the introduction of Sip Til Send, patients often underwent liquid fasts for prolonged periods as surgeries can sometimes face scheduling delays,” said Dr. Fernando Arduini, Consultant Anaesthetist and Clinical Lead Perioperative Medicine at Grampians Health.
“Allowing patients to sip clear liquids will help them to maintain fluid balance in the body and remain hydrated, reducing the risk of having multiple IV cannulations and complications associated with surgeries. Sip Til Send is a simple, safe and kind way to achieve this.”
Dr Arduini also highlighted the positive impact of Sip Til Send on patients undergoing emergency surgery.
“The Sip Til Send method may be of particular value in preventing prolonged fasting for inpatients waiting for an emergency surgery where there may be frequent delays due to lack of theatre access.”
Grampians Health conducts around 10,000 surgeries and procedures annually across its sites in Ballarat, Horsham and Stawell. Sip Til Send approach would be applied to all surgical/procedural patients across the health service.
Ahead of a surgery/procedure requiring sedation, patients can now consumer water, coffee (without milk), tea (without milk), ice cubes/ clear icy poles, pulp-free and clear fruit juice e.g. apple juice, Cordial, electrolyte solution like hydralyte and sports drinks like Gatorade. Alcohol is not allowed under Sip Til Send.
However, Sip Til Send might not be suitable for certain categories of patients such as those who are ‘nil by mouth’ for medical or surgical reasons, pregnant patients who are already in labour and undergoing an emergency caesarean section, and patients having procedures without an anaesthetist present.
“More importantly, all patients who are eligible to do so are encouraged to practice Sip Til Send but they are not forced to,” said Dr Arduini.
The Sip Til Send initiative is endorsed by the Department of Health, Victoria through Safer Care Victoria and by the Australian and New Zealand College of Anaesthetists.