# Detection of Gelatinous Candy on Gastric Ultrasound During Preoperative Nil per Os Evaluation

## TL;DR

Gummy bears can be detected in the stomach via ultrasound before surgery, raising questions about preoperative fasting guidelines and anesthesiologist practices.

## Contribution

This paper introduces gastric ultrasound as a tool to detect gelatinous candy in preoperative patients and highlights variability in anesthesiologist practices.

## Key findings

- Gummy bears consumed two hours prior were visible on gastric ultrasound.
- Anesthesiologists lack consensus on preoperative gastric ultrasound necessity and NPO duration.
- Variability in anesthesiologist opinions highlights the need for standardized guidelines.

## Abstract

Perioperative pulmonary aspiration of gastric contents can lead to serious complications, including pneumonitis and pneumonia, which may result in significant morbidity and mortality. A 52-year-old man with a history of hypertension and diabetes presented to the hospital for emergent debridement of bilateral lower-extremity non-healing ulcers.He mentioned consuming gummy bears two hours prior to presentation, although his last substantial solid meal had occurred 14 hours earlier.Preoperatively, a gastric ultrasound revealed the presence of gummy bears within the stomach, prompting the anesthesia team to implement preventive measures to minimize aspiration risk.

We also conducted a survey to evaluate anesthesiologists' perceptions regarding the timing of patients' consumption of gummy bears before elective procedures. The survey results indicated a lack of consensus regarding the necessity of preoperative gastric ultrasound and the duration of nothing-by-mouth (NPO) status before elective procedures. Variability in skill levels and opinions among anesthesiologists regarding the optimal waiting period before surgery underscores the need for further research and standardization in these domains, highlighting the potentially critical role of gastric ultrasound in perioperative settings.