DURHAM, NC – Stating that the outside world contains enough variables to make pulmonary aspiration a true and serious risk, hospitalist Mack Reynolds has told his patient that he should remain NPO after discharge later today.
“Sleeping in one’s own bed, lying down in the park, laying on a beach, a headstand, any one of these things could potentially lead to stomach contents coming up and ending up in the lungs, leading to some very serious complications,” Reynolds explained, adding that he asked one of the nutritionists to come by and go over every food and beverage he has to avoid indefinitely once he leaves. “So I told him it is better not eating at all once he leaves the hospital property.”
Making a patient NPO before an elective procedure is becoming increasingly called into question. However, Reynolds, an older hospitalist in his twentieth year of practice, considers himself an old guard clinician, and still believes in the merits of it. Which is why he wanted to push the envelope in a different direction.
“The patient had some great questions for me, like can I ever eat again?” Reynolds said. “I told him no, you can’t.”
This is the first time in medical history any health care professional has ordered for their patient to be NPO after discharge.
“When the patient is hospitalized,” Reynolds reasoned, “we have a little more control of the environment, based on what we can order, based on how closely we can supervise these patients. You lose all of that when they’re ready to be discharged. Making them NPO after they leave the hospital protects you from all those possibilities.”
Reynolds’ patient has some reservations, especially after reading about a patient who died of starvation because he was NPO for two hours. But ultimately he decided he will take his doctor’s advice.
“The way I see it this solves two problems,” the patient told Gomerblog. “One, I won’t aspirate. Two, I’ve been constipated my whole life, so this is a perfect solution. Can’t be constipated if you don’t make poop, right?”