Royal Adelaide Hospital introduces Sip Til Send

07 August 2023

The Royal Adelaide Hospital (RAH) will become the first hospital in the state to allow patients to drink fluids up until they go to surgery as part of an initiative called Sip Til Send.

Sip Til Send allows patients to sip from a standard ward cup, equivalent to 200 millilitres, of liquid every hour until their surgery. Patients can drink suitable clear liquids such as water and ice as well as diluted cordial, and black tea or coffee.

First introduced at the Ninewells Hospital and Medical School in Scotland in 2021, the approach has been adopted by all Scottish Orthopaedic and Trauma centres and several National Health Service (NHS) trusts. The team in Scotland are now supporting more than 50 rollouts across the world.

The RAH will introduce the policy for all surgeries on Tuesday 8 August, making it the second hospital in Australia to implement the program after it was rolled out at the Prince of Wales hospital in Sydney in July.

Traditionally, all patients undergoing surgery are required to fast from liquids for at least two-hours prior to reduce the risk of aspiration under anaesthesia which can be fatal.

Unfortunately, patients requiring surgery often end up fasting for far longer than necessary for several reasons such as cases taking longer than anticipated and changes to lists due to emergency priority of cases.

In recent years, a growing number of studies have shown that fasting guidelines are out of step with clinical practice as it is almost impossible to meet the times in the guideline. It is actually far safer for patients to consume a small amount of liquid before surgery than the harm caused by prolonged fasting.

This is due to the risk of aspiration being very low and dehydration often leading to more problems especially for older patients.

Sip Til Send has been shown to lead to safer and better clinical outcomes, keeping patients hydrated so they feel better, improving wellbeing and reducing postoperative complications, nausea and vomiting.

Patients at the RAH will still be required to food fast for at least six hours before their surgery, while some patients will be exempt from Sip Til Send for medical or surgical reasons.

Statement attributable to Central Adelaide Local Health Network (CALHN) Surgery Program Nurse Lead, Kristian Sanchez

The RAH is leading the way in South Australia, becoming the first hospital to ease strict liquid restrictions so surgery patients can now drink clear fluids right up until they go into theatre.

We are working closely with the lead anaesthetist and nursing team for this project in Scotland to ensure we adopt this new policy as smoothly and effectively as possible.

Fluid fasting can be uncomfortable so we hope this change will help ease our patient’s anxiety and prevent postoperative complications associated with dehydration.

Statement attributable to CALHN CEO, Professor Lesley Dwyer

Sip Til Send aims to end unnecessary prolonged fasting, providing better experiences and outcomes for our patients.

The initiative has been extremely well received by staff and patients at other sites, so we look forward to implementing this initiative at the RAH.