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Nutrition, PICU, Initiation and Advancement — Interruptions — Clinical Pathway: ICU and Inpatient

Nutrition Initiation and Advancement Clinical Pathway — PICU/PCU

Scheduled & Unscheduled Interruptions: Recommendations for Resuming Feeds

Elective and/or emergent procedures: radiological studies/interventions, OR, bedside procedure…etc.

Stopping & Resuming Feeds

  • Follow appropriate NPO guideline & place on maintenance IVF prior to procedure
  • Discontinue feedings
    • For emergent procedure (if possible), aspirate gastric contents via feeding tube to empty the stomach; consider sump placement to drain stomach contents.
    • Aspirating gastric contents may not fully empty the stomach. Follow all precautions for prevention of aspiration.
  • Following completion of procedure/transport, return patient to pre-procedure/transport status
  • Resume feeds when deemed appropriate by clinical team:
    • Within 24 hours of procedure – restart at the last tolerated rate & resume pathway advance.
    • ≥ 24 hours after procedure – restart at ½ the last tolerated rate & resume pathway advance.
    • For surgical procedures, defer to surgery team for resuming feeds.
  • If not tolerated, determine etiology of intolerance & follow feeding guideline.
  • Continue to advance feedings according to the feeding guideline.

NPO Guidelines by Procedure Area

Pre-Anesthesia/Sedation Feeding Guidelines Algorithm

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