Background: Patients are frequently ordered to fast while hospitalized. Though these “nil per os” (NPO) orders are often placed for sound clinical reasons (e.g. small bowel obstruction), they are also frequently placed in preparation for imaging studies or procedures to reduce the theoretical risk of aspiration. There is often a great deal of confusion among […]

Case Presentation: A 69‐year‐old man with a history of hypertension presented to an outside hospital emergency department (ED) with nonradiating substernal chest pressure that woke him at 2 am. He had experienced such pain before and attributed it to reflux. When the pain remained unchanged hours after omeprazole, he presented to the ED. There, he […]

Background: Hospitalized patients are often kept fasting for various reasons, including clinical conditions, procedures and imaging, or dysphagia (1). Studies have demonstrated the harm of excessive fasting, including increased post-operative delirium (2), thirst and hunger, and patient dissatisfaction. Accordingly, recent guidelines have promoted a more liberal preoperative fasting strategy, namely, allowing clear liquids up to […]

Case Presentation: A 48‐year‐old man with a 1‐year history of generalized pruritic rash presented with lethargy. His temperature was 99°F, pulse 80, and blood pressure 141/99 mm Hg. Exam revealed a regular heart beat, clear lung exam, and a benign abdominal exam. His exam was also notable for dry skin with scattered erythematous maculopapular rash […]