Sip Til Send

This information is for clinicians managing fasting times for patients who are waiting for surgery or sedation.

What is Sip Til Send?

Sip Til Send is an emerging practice used to reduce fluid fasting duration in patients waiting for surgery. It allows patients to sip approved clear liquids up until the time of being sent to theatre for their surgery.

Sip Til Send is also known as ‘drink until called’.

What are approved clear liquids?

In this use, clear liquids means:

• water
• ice
• black or herbal tea or coffee (no milk)
• rehydration or electrolyte drinks
• glucose 5% solution.

How much liquid is allowed?

Sip Til Send allows adult patients to sip from a standard ward cup (up to 200 millilitres) every hour until their surgery.

Children are allowed three millilitres per kilogram of body weight per hour until their surgery.

Why use Sip Til Send?

Sip Til Send has been shown to reduce:

• fluid fasting duration
• postoperative complications
• nausea
• vomiting
• thirst
• dehydration.

It may also result in improved patient satisfaction.

There is no reported evidence for increased aspiration risk with Sip Til Send compared to standard fasting guidance, e.g. nil by mouth from two hours before surgery. However, all patients should receive individual assessment of aspiration risk as part of their anaesthetic assessment.

Exceptions

• All patients who have been assessed as at risk of aspiration.
• Patients on modified textured fluids or nil by mouth for medical or surgical reasons. These patients may moisten their lips and mouth with water.
• Liquids containing fat, protein and insoluble fibre are excluded.
• Clear soups, thickened fluids and jelly that may be included in a ‘clear fluid diet’ are not suitable for Sip Til Send.