Houston Methodist. Leading Medicine

Hip FAQ

Question:

My uncle is in the hospital for a hip fracture. I heard he waited in the emergency department for 48-hours with nothing to eat or drink before they did the surgery. This seems abusive to me. Is it standard procedure? Can't something be done to speed up the process?

Answer:

Delays in surgery for emergencies like hip fractures are not uncommon. There are two basic reasons for this. One is patient-related. This refers to individual medical problems that might be present that could make anesthesia and surgery too dangerous at the time. For example, extremely high blood pressure or uncontrolled diabetes puts a patient at risk for complications during or after surgery. Once those problems have been taken care of, then surgery can proceed. The second most common reason for delays in surgery is system-related. This could be anything from the lack of an available operating room to inadequate support staff. If there isn't an orthopedic surgeon, scrub nurse, or anesthesiologist available, then surgery is delayed. Meanwhile, the patient is NPO, which is a Latin phrase (nil per os) that means nothing by mouth. No food or drinks are allowed to avoid any choking, vomiting, or complications during anesthesia. Of course, this policy can have the effect of dehydrating and weakening the patient. These are additional factors that make for potential problems recovering from surgery because of a weakened state. The hospital staff tries to take all these things into consideration when planning and scheduling emergency surgeries. Sometimes delays are unavoidable. In other cases, the underlying cause for delays can be changed or modified. For example, if a hospital routinely has surgery delays greater than 24 hours, then resource management is an issue that should be addressed and changed. It may be helpful to let the hospital administrator know of your family's experience. This could bring about modifications that can help many patients. Amer N. Al-Ani, MD, et al. Early Operation on Patients with a Hip Fracture Improved the Ability to Return to Independent Living. In The Journal of Bone and Joint Surgery. July 2008. Vol. 90-A. No. 7. Pp. 1436-1442.

*Disclaimer:* The information contained herein is compiled from a variety of sources. It may not be complete or timely. It does not cover all diseases, physical conditions, ailments or treatments. The information should NOT be used in place of visit with your healthcare provider, nor should you disregard the advice of your health care provider because of any information you read in this topic.
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