A study at John Hopkins, by Martin Makary, M.D., M.P.H,. and his co-authors are urging change of common protocols that currently have patients who are already extremely ill, fasting for hours, in case they need surgery.
Sleep deprivation and malnutrition should be monitored more closely in hospitals because these practices have a negative impact on all patients, especially the elderly. Makary says, “Surgery takes a huge physiologic toll on the body, and forcing sick people, especially the elderly, who are already in a frail state, to fast for eight to 12 hours, or even days, before surgery, only amplifies that stress on the body,”
Makary is calling on all hospitals to review their current practices and adopt protocols that help to improve patient outcomes through nutrition and rest.
The John Hopkins commentary describes a typical case of a 65-year old patient who is admitted with a severe case of pneumonia and has been too sick and weak to eat for several days. As soon as she reaches the emergency room, the patient is placed on NPO in case she requires surgery. If surgery is required the patient's diet is scarce, and the constant monitoring and noise makes sleep impossible.
As Makery points out, a healthy person who is subjected to the same lack of sleep and nutrition would show signs of a weakened immune system, impaired judgment and severe fatigue within 24-hours.
When I worked in the operating room, we would bring elderly patients from the floor and prep them for surgery. They would often go all day without food in a loud environment. Their surgery would often take place after the surgeon completed his office hours and finished rounds, around 6:30 pm. Many of these patients were diabetic. I know I certainly would not be a fan of being treated with such disregard as a patient.
I hope hospitals worldwide adopt a more compassionate attitude concerning patient's sleep and nutritional needs. There's no reason for any patient to placed on NPO status for longer than 8 hours, in the case that they may need surgery.
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