Nicole Fein, DVM, DACVIM on Instagram: "Time to retire “NPO after midnight.” The 2020 AAHA anesthesia guidelines recommend patient-specific fasting protocols to minimize stress, hypoglycemia, and aspiration risk. ✅ Healthy adults: 4–6 hr fast, water until 1–2 hr prior ✅ Neonates/small patients: 1–2 hr fast ✅ Diabetics: ½ meal 2–4 hr before, adjust insulin ✅ Regurgitation risk: light meal 4–6 hr prior 🚨 Emergencies: stabilize first Prolonged fasting can increase gastroesophageal reflux and delay

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