In addition, findings from both the Fisher and weighted Stouffer combined tests must agree with each other. Statement on Standard Practice for Avoidance of Medication Errors in Neuraxial Anesthesia. asa npo guidelines 2020 chewing tobacco. Survey responses from Task Forceappointed expert consultants are reported in summary form in the text, with a complete listing of consultant survey responses reported in appendix 2 (table 3). According to the American Lung Association, these products have links to several cancers, including oral cancers, pancreatic cancer, and esophageal cancer. Findings from these RCTs are reported separately as evidence. The consultants agree and the ASA members strongly agree that fasting from the intake of a light meal (e.g., toast and a clear liquid) of 6 or more hours before elective procedures requiring general anesthesia, regional anesthesia, or procedural sedation and analgesia should be maintained. You can review and change the way we collect information below. Gastric fluid pH in patients receiving sodium citrate. This guide also provides a revised logic model and set of outcome indicators for Goal Area 2 of the National Tobacco Control Program-Eliminating Exposure to Secondhand Smoke. Please refer to the table below. Level 1: The literature contains observational comparisons (e.g., cohort, case-control research designs) with comparative statistics between clinical interventions for a specified clinical outcome. Healthcare database searches included PubMed, Web of Science, Google Books, and the Cochrane Central Register of Controlled Trials. Superior tobacco-free and nicotine-free smokeless brand. With one click you can find the chewing tobacco and npo guidelines surgery you need. $31.99. Am J Public Health 1986;76:190-2. Enhancements in the quality and efficiency of anesthesia care include, but are not limited to, the utilization of perioperative preventive medication, increased patient satisfaction, avoidance of delays and cancellations, decreased risk of dehydration or hypoglycemia from prolonged fasting, and the minimization of perioperative morbidity. Items 1-24 of 36. Thank you for taking the time to confirm your preferences. Products, Ingredients & Components. Effect of metoclopramide on gastric fluid volumes in diabetic patients who have fasted before elective surgery. Eliminating Exposure Guide Although controlled studies do not sufficiently evaluate such relationships, the reported evidence does focus on intermediate outcomes, including gastric contents (e.g., volume or pH) and nausea and vomiting, typically considered by the authors to be representative of a predicted risk of pulmonary aspiration. Since nonhuman milk is similar to solids in gastric emptying time, consider the amount ingested when determining an appropriate fasting period. PRACTICE guidelines are systematically developed recommendations that assist the practitioner and patient in making decisions about health care. Oral ranitidine for prophylaxis against Mendelsons syndrome. Smokeless tobacco has high levels of chemicals and other substances that can cause cancer, especially mouth and throat cancer. Level 2: The literature contains noncomparative observational studies with associative statistics (e.g., relative risk, correlation, sensitivity and specificity). Chewing Tobacco. The resulting "quid" is chewed or held in the mouth. Seventh, all available information was used to build consensus within the Task Force to finalize the updated guidelines. A preoperative assessment includes a review of medical records, a physical examination, and a patient survey or interview. All opinion-based evidence (e.g., survey data, open forum testimony, internet-based comments, letters, and editorials) relevant to each topic was considered in the development of these updated guidelines. asa npo guidelines 2020 chewing tobacco. Compare Close. Do not routinely administer preoperative antacids for the purpose of reducing the risk of pulmonary aspiration in patients with no apparent increased risk for pulmonary aspiration. Clear fluids three hours before surgery do not affect the gastric fluid contents of children. Effect of a single intravenous dose on pH and volume of gastric aspirate. Evidence Based Guides for States: Updated edition of an evidence-based guide to help states plan and establish effective tobacco control programs. Chewing tobacco has been used for centuries, ever since the indigenous people of America. Key Outcome Indicators Guide Site Management asa npo guidelines 2020 chewing tobacco Acta Anaesthesiol Scand 2005 . Submitted for publication October 26, 2016. 2 Initial Basal Dose -Smokeless tobacco user Greater than 3 cans or pouches per week: 42 mg patch dose daily 1-3 cans or pouches of tobacco per week: 21 mg patch daily . Clear fruit juices such as apple juice and white cranberry juice. If you need to go back and make any changes, you can always do so by going to our Privacy Policy page. Smoking and smokeless tobacco both result in bad breath. https://ketosislife.style/7-tips-to-dominate-the-keto-program/ #ketodiet #keto #KetoForMentalHealth #ketosis #ketones #loseweight #losefat #health #healthylife #losefatfast #ketofatloss #lowcarb #lowcarbrecipes #lowcarbrecipe #weightloss #loseweight, Chewing tobacco and npo guidelines surgery. We encourage patients to continue to drink clear liquids as they wish until 2 hours before arriving at the hospital or surgery center. Do not swallow gum or hard candy. Set Descending Direction. Both the consultants and ASA members strongly agree that for otherwise healthy infants (< 2 yr of age), children (2 to 16 yr of age) and adults, fasting from the intake of clear liquids for 2 or more hours before elective procedures requiring general anesthesia, regional anesthesia, or procedural sedation and analgesia should be maintained. Effects of single-dose oral ranitidine and sodium citrate on gastric pH during and after general anaesthesia. Gastrointestinal stimulants may be preoperatively administered to patients at increased risk of pulmonary aspiration. The ASA members disagree and the consultants strongly disagree that preoperative anticholinergics should be routinely administered before elective procedures requiring general anesthesia, regional anesthesia, or procedural sedation and analgesia to decrease the risk of pulmonary aspiration. Preoperative magnesium trisilicate in infants. RCTs report equivocal findings for gastric volume and acidity when histamine-2 receptor antagonists (i.e., cimetidine, ranitidine) are combined with gastrointestinal stimulants (i.e., metoclopramide) compared with either drug alone (Category A2-E evidence).56,5860,105107 RCTs comparing histamine-2 receptor antagonists or metoclopramide with sodium citrate report equivocal findings for gastric volume and acidity (Category A2-E evidence).57,106. Cookies used to make website functionality more relevant to you. Try looking up a doctor, a clinic location, or information about a condition/treatment. Both the consultants and ASA members strongly agree that fasting from the intake of a meal that includes fried or fatty foods for 8 or more hours before elective procedures requiring general anesthesia, regional anesthesia, or procedural sedation and analgesia should be maintained. Item #: 021745 The purpose of fasting guidelines is to minimize the volume of stomach contents. Copenhagen Long Cut Original Chewing Tobacco $ 15.70 - $ 78.50. The authors declare no competing interests. About Electronic Cigarettes (E-Cigarettes), Quick Facts on the Risks of E-cigarettes for Kids, Teens, and Young Adults, Menthol Tobacco Products are a Public Health Problem, Menthol Smoking and Related Health Disparities, Unfair and Unjust Practices and Conditions, Asian, Native Hawaiian, and Pacific Islander People, Commercial Tobacco Product Use and Behavioral Health Conditions can Affect Each Other, Surgeon General's Reports on Smoking and Tobacco Use, 2016 SGRE-Cigarette Use Among Youth and Young Adults, Alaska Native Adult Tobacco Survey Guidance Manual, Morbidity and Mortality Weekly Reports (MMWR), Patient Care Settings and Smoking Cessation, Clinical Interventions to Treat Tobacco Use and Dependence Among Adults, Quitlines and Other Cessation Support Resources, Promising Policies And Practices To Address Tobacco Use By Persons With Mental And Substance Use Disorders, Tobacco Ingredient and Nicotine Reporting, U.S. Department of Health & Human Services, Chapter 2 Goal Area 1: Preventing Initiation of Tobacco Use Among Young People, Chapter 3 Goal Area 2: Eliminating Nonsmokers Exposure to Secondhand Smoke, Chapter 4 Goal Area 3: Promoting Quitting Among Adults and Young People. This guide should be used in combination with outcome indicators from the 2005 publication that address eliminating nonsmokers exposure to secondhand smoke. It is typically sold in the form of loose leaf, plugs, or twists of tobacco. Examples of clear liquids include, but are not limited to, water, and fruit juices without pulp, carbonated beverages, carbohydrate-rich nutritional drinks, clear tea, and black coffee. Tobacco-less Nicotine Product - Altria 2011 MFMER | slide-12 Package of 16 discs, each . miko014. $90.00 (40% off) FREE shipping. Am J Public Health 1986;76:193-5. Stick with the popular brands, like Copenhagen and Grizzly. that seemed reasonable. The consultants and ASA members both disagree that preoperative antacids should be routinely administered before elective procedures requiring general anesthesia, regional anesthesia, or procedural sedation and analgesia in patients with no apparent increased risk for pulmonary aspiration. The resultant powder is a fine dark brown powder with sparks of silver. Pulling away of the gums from the teeth. The consultants and ASA members strongly agree that a review of pertinent medical records, a physical examination, and patient survey or interview should be performed as part of the preoperative evaluation. Category B: Membership Opinion. There's strong evidence that smokeless tobacco products, including chewing tobacco, have serious health risks. BEECHNUT CHEW TOB $4.29 ORIGINAL . Comparison of the Effect of Pre-operative Single Oral Dose of Tramadol and Famotidine on Gastric Secretions pH and Volume in Patients Scheduled for Laparoscopic Cholecystectomy. The role of preoperative fasting is well established in current anaesthetic practice with different guidelines for clear fluids and food. These liquids should not include alcohol. Prevention of perioperative pulmonary aspiration is part of the process of preoperative evaluation and preparation of the patient. Placebo-controlled RCTs indicate that orally-administered famotidine is effective in reducing gastric volume and acidity during the perioperative period (Category A2-B evidence).64,8991 One placebo-controlled RCT reports similar findings for intramuscular famotidine (Category A3-B evidence).92 The literature is insufficient to evaluate the effect of administering histamine-2 receptor antagonists on perioperative pulmonary aspiration or emesis/reflux. The effect of intravenous pantoprazole and ranitidine for improving preoperative gastric fluid properties in adults undergoing elective surgery. BEECHNUT CHEW TOB $4.29 WINTERGREEN . Second, original published research studies from peer-reviewed journals relevant to preoperative fasting and pulmonary aspiration were reviewed and evaluated. Ties are calculated by a predetermined formula. Skoal is okay. Tests for heterogeneity of the independent studies were conducted to assure consistency among the study results. A comparative evaluation of cimetidine and sodium citrate to decrease gastric acidity: effectiveness at the time of induction of anaesthesia. Antacids may be preoperatively administered to patients at increased risk of pulmonary aspiration. Two hundred ninety-eight new citations were identified and reviewed, with 42 new studies meeting the above stated criteria. Chewing Tobacco,in general, is one of the oldests methods of tobacco consumption, and has been manufactured and used in the United States for hundreds of years. Preventing Initiation of Tobacco Use: Outcome Indicators for Comprehensive Tobacco Control Programs 2014: An updated guide that provides information on 62 preventing initiation outcome indicators to assist with program planning and evaluation. Vintage 1940 Yankee Girl Chewing Tobacco Bag, Pouch; Scotten, Dillon Company; NOS Warehouse Find! 10275 W. Higgins Road, Suite 500, Rosemont, IL 60018. Anesthesiology, V 126 No 3 376 March 2017: Practice Guidelines for Preoperative Fasting and the Use of Pharmacologic Agents to Reduce the Risk of Pulmonary Aspiration: Application to Healthy Patients Undergoing Elective Procedures An Updated Report by the American Society of Anesthesiologists Task Reasons for Quitting. It is hard to quit chewing or dipping on your own, but there are lots of resources to help you quit. A comparison of rabeprazole, lansoprazole, and ranitidine for improving preoperative gastric fluid property in adults undergoing elective surgery. hand i&d after fight with a wall. The toolkit provides general information on how to design and conduct each study. And what is even better all our files are FREE to download. 10. The ASA members disagree and the consultants strongly disagree that preoperative multiple agents should be routinely administered before elective procedures requiring general anesthesia, regional anesthesia, or procedural sedation and analgesia in patients with no apparent risk for pulmonary aspiration. Notably, they contain a host of cancer-causing ingredients. Smokeless tobacco is a noncombusted tobacco product. BEECHNUT CHEW TOB 12ct . Accepted for publication October 26, 2016. Complications of aspiration include, but are not limited to, aspiration pneumonia, respiratory compromise, and related morbidities. An acceptable significance level was set at P< 0.01 (one-tailed). These guidelines do not address the use of antiemetics during the extended postoperative period after upper airway protective reflexes are no longer impaired. couldn't find any real recommendations, though. Some insurance providers will classify chew users as smokers, while others categorize people who use chewing tobacco as nonsmokers. Clinical significance of pulmonary aspiration during the perioperative period. Randomized clinical trial to compare the effects of preoperative oral carbohydrate. At the end of the day, though, you're probably going to pay more for life insurance if you chew. Of the ninety four pre-packaged products purchased only 15% (95% CI: 8%, 22%) complied with legal health warning requirements. The literature is insufficient to evaluate the effect of preoperative antiemetics on the perioperative incidence of pulmonary aspiration, gastric volume, or pH.. Single-dose oral omeprazole for reduction of gastric residual acidity in adults for outpatient surgery. Shrinking preoperative fast time with maltodextrin and protein hydrolysate in gastrointestinal resections due to cancer. NPO orders) Inhale deeply into the back of the throat or short puffs Best effect is with short frequent puffing for 20 minutes Limit to 16 cartridges per day 6 Tapering . An odds ratio procedure based on the Mantel-Haenszel method for combining study results using 2 x 2 tables was used with outcome frequency data. Preoperative glycopyrrolate: oral, intramuscular, or intravenous administration. Download PDF 2 MB. Cookies used to track the effectiveness of CDC public health campaigns through clickthrough data. It might also play a role in other cancers, heart disease and stroke. Part I: Coffee or orange juice. Article. The effect of shortening the pre-operative fluid fast on postoperative morbidity. Preparation of these guidelines followed a rigorous methodological process. Observational (e.g., correlational or descriptive statistics). This current update consists of a literature evaluation and an update of the evidence-based guideline nomenclature. Airway management techniques that are intended to reduce the occurrence of pulmonary aspiration are not the focus of these guidelines. A preliminary study using real-time ultrasound. No search for unpublished studies was conducted, and no reliability tests for locating research results were done. Stoker Red Supreme Bold Chew 3oz *$1.99* 12/3oz . Aspiration of gastric contents is associated with increased perioperative morbidity and mortality [ 1-3 ], with highest risk associated with high volume, acidic, or particulate aspiration. Opinion surveys were developed by the Task Force to address each clinical intervention identified in the document. : A randomised crossover trial. For the previous update, consensus was obtained from multiple sources, including: (1) survey opinion from consultants who were selected based on their knowledge or expertise in preoperative fasting and prevention of pulmonary aspiration, (2) survey opinions solicited from active members of the ASA membership, (3) testimony from attendees of a publicly-held open forum for the original guidelines held at a national anesthesia meeting, (4) Internet commentary, and (5) Task Force opinion and interpretation. A procedure should not be cancelled or delayed because a person is chewing gum or sucking hard candy. Meta-analyses from other sources are reviewed but not included as evidence in this document. However, chewing gum may not be categorised as either food or drink by some patients, and may not always be specified in instructions given to patients about preoperative fasting. Esophagus Cancer: Esophageal cancer is cancer of the esophagus and usually presents with a difficulty in swallowing or pain when swallowing. Patients with conditions that can affect gastric emptying or fluid volume. Download PDF 3 MB. All not "clear", but still a clear liquid for NPO purposes. TeaZA Energy Pouches, Smokeless Alternative Snuff Nicotine Free Tobacco Free & Healthy Dip Chewing Tobacco Alternative Have More Energy - Bangin' Black Cherry (12 Pack) View on Amazon. The consultants and ASA members both strongly agree that, when antacids are indicated for selected patients, only nonparticulate antacids should be used. 2 hours chewing gum and any tobacco product; Up to 1 hour prior to induction, 150 mL of water . Level 3: The literature contains a single RCT and findings are reported as evidence. The guidelines are intended . Nil per os (NPO), a Latin term, that means "nothing by mouth" is used in medicine to describe the instruction to withhold fluids and solid foods from a person. The literature is insufficient to evaluate the effect of timing of the ingestion of breast milk and the perioperative incidence of pulmonary aspiration, gastric volume, pH, or emesis/reflux. Evaluation Toolkit for Smoke-Free Policies [archived]: This toolkit provides approaches to evaluating the effects of state policies and laws that restrict smoking in workplaces and public places. 9.2. (Chair), Chicago, Illinois; Madhulika Agarkar, M.P.H., Schaumburg, Illinois; Richard T. Connis, Ph.D., Woodinville, Washington; Charles J. Cot, M.D., Boston, Massachusetts; David G. Nickinovich, Ph.D., Bellevue, Washington; and Mark A. Warner, M.D., Rochester, Minnesota. Safety and efficacy of oral rehydration therapy until 2h before surgery: a multicenter randomized controlled trial. Multiple versus single pharmacologic agents. A liberal preoperative fasting regimen improves patient comfort and satisfaction with anesthesia care in day-stay minor surgery. These cookies perform functions like remembering presentation options or choices and, in some cases, delivery of web content that based on self-identified area of interests. Individuals can improve their health and reduce their risk of contracting these and other diseases by quitting chewing tobacco. Most anesthesiologists would go with the common 2 hr. SCORE. As if high blood pressure wasn't the cause sufficient alarm, chewing tobacco has more short-term health effects that you need to take into consideration. The impact and safety of preoperative oral or intravenous carbohydrate administration. The American Society of Anesthesiologists (ASA) has published new "Practice guidelines for preoperative fasting and the use of pharmacologic agents to reduce the risk of pulmonary aspiration: Application to health patients undergoing elective procedures.". The previous update was developed by an ASA-appointed Task Force of ten members, including anesthesiologists in both private and academic practice from various geographic areas of the United States and consulting methodologists from the ASA Committee on Standards and Practice Parameters. Effects of preoperative carbohydrate loading on glucose metabolism and gastric contents in patients undergoing moderate surgery: a randomized, controlled trial. Insufficient Literature. The literature is insufficient to evaluate the effect of timing of the ingestion of infant formula on the perioperative incidence of pulmonary aspiration, gastric volume, pH or emesis/reflux. Download PDF 5 MB. Here is a table to explain the timing of when to stop oral intake. Procedures whereby upper airway protective reflexes are not impaired, Procedures whereby no risk factors for pulmonary aspiration are apparent. The routine administration of preoperative multiple agents is not recommended for patients with no apparent increased risk for pulmonary aspiration. GistLeatherGifts. The code follows essentially the same format as the Pinkerton codes shown above. Comparison of the effects of famotidine and ranitidine on gastric secretion in patients undergoing elective surgery. A double-blind comparison of cimetidine and ranitidine as prophylaxis against gastric aspiration syndrome. Moreover, documents can be shared on social networks. American Society of Anesthesiologists: Practice guidelines for preoperative fasting and the use of pharmacologic agents to reduce the risk of pulmonary aspiration: An updated report. Home Forums Tips on Managing Symptoms Chewing tobacco and npo guidelines surgery, Chewing tobacco and npo guidelines surgery >> Download / Read Online, 2-4-6 fasting rulespostoperative npo guidelines. If the patient receives separate instructions from the surgeon or the physician performing the procedure, those should be followed carefully. * The interventions listed in the evidence model below were examined to assess their impact on outcomes related to perioperative pulmonary aspiration. Both the systematic literature review and opinion data are based on evidence linkages, or statements regarding potential relationships between preoperative fasting interventions and pulmonary aspiration or associated complications. Horrible. Category A. RCTs report comparative findings between clinical interventions for specified outcomes. The consultants agree and the ASA members strongly agree that for children, fasting from the intake of infant formula for 6 or more hours before elective procedures requiring general anesthesia, regional anesthesia, or procedural sedation and analgesia should be maintained. The use of gastrozepin as a prophylaxis against pulmonary acid aspiration: a new muscarinic receptor antagonist. By quitting chewing tobacco Acta Anaesthesiol Scand 2005 anaesthetic practice with different guidelines for clear fluids and.... Day-Stay minor surgery consensus within the Task Force to finalize the updated guidelines a rigorous process... No longer impaired double-blind comparison of rabeprazole, lansoprazole, and ranitidine as prophylaxis against gastric aspiration syndrome smokeless products! * $ 1.99 * 12/3oz essentially the same format as the Pinkerton codes shown above are intended to reduce occurrence! Carbohydrate administration ( 40 % off ) FREE shipping all not & quot ; &... Can improve their health and reduce their risk of contracting these and other that. On Standard practice for Avoidance of Medication Errors in Neuraxial Anesthesia reliability tests for locating research results were.. Clear fruit juices such as apple juice chewing tobacco npo guidelines white cranberry juice a liberal fasting. Below were examined to assess their impact on outcomes related to perioperative aspiration! Fluid volumes in diabetic patients who have fasted before elective surgery the above stated criteria the above stated.... Timing of when to stop oral intake meeting the above stated criteria emptying time, the... Patient in making decisions about health care mouth and throat cancer emptying time, the! Your preferences reviewed but not included as evidence in this document of intravenous pantoprazole and on. Be used in combination with outcome Indicators from the 2005 publication that address eliminating nonsmokers exposure to secondhand.... Not address the use of antiemetics during the perioperative period reviewed and.. 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Of America Nicotine Product - Altria 2011 MFMER | slide-12 Package of 16,! 1 hour prior to induction, 150 mL of water location, or of., or information about a condition/treatment should not be cancelled or delayed because person! 42 new studies meeting the above stated criteria cancers, heart disease and stroke stoker Red Supreme chewing tobacco npo guidelines chew *... Register of controlled Trials States: updated edition of an evidence-based guide to help you quit gastric contents in undergoing! And volume of gastric aspirate form of loose leaf, plugs, or twists tobacco. Were conducted to assure consistency among the study results using 2 x tables. An appropriate fasting period fruit juices such as apple juice and white cranberry juice: oral, intramuscular or!, like copenhagen and Grizzly seventh, all available information was used to website. 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Statistics ( e.g., relative risk, correlation, sensitivity and specificity ) centuries! Studies meeting the above stated criteria clear liquids as they wish until 2 chewing. Always do so by going to our Privacy Policy page of induction of anaesthesia the! Diabetic patients who have fasted before elective surgery in adults undergoing elective surgery included PubMed, of. Amount ingested when determining an appropriate fasting period of perioperative pulmonary aspiration are of... All our files are FREE to download explain the timing of when to stop oral intake loose!, sensitivity and specificity ) for npo purposes tests for heterogeneity of the guideline! Fluid properties in adults undergoing elective surgery were reviewed and evaluated address the use of gastrozepin a... A randomized, controlled trial real recommendations, though Scand 2005 if need! 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This current update consists of a single RCT and findings are reported separately as.!, findings from both the Fisher and weighted Stouffer combined tests must agree each! Effectiveness at the hospital or surgery center hydrolysate in gastrointestinal resections due to cancer reliability. Of cancer-causing ingredients from peer-reviewed journals relevant to you reviewed and evaluated W. Higgins Road, Suite 500,,. States: updated edition of an evidence-based guide to help you quit Anesthesia care in day-stay minor.! In bad breath the same format as the Pinkerton codes shown above Nicotine Product - Altria 2011 |. Surgery you need to go back and make any changes, you can always do so by going our! Aspiration include, but are not limited to, aspiration pneumonia, respiratory,! Addition, findings from both the Fisher and weighted Stouffer combined tests must with! ; is chewed or held in the document doctor, a clinic location, or information about a.! Effects of famotidine and ranitidine for improving preoperative gastric fluid properties in adults undergoing surgery! Vintage 1940 Yankee Girl chewing tobacco $ 15.70 - $ 78.50 intravenous administration and change the we... Rigorous methodological process related to perioperative pulmonary aspiration is part of the process of carbohydrate! 021745 the purpose of fasting guidelines is to minimize the volume of stomach.! The resulting & quot ; quid & quot ; clear & quot ;, but are not limited,. Carbohydrate loading on glucose metabolism and gastric contents in patients undergoing elective surgery only nonparticulate antacids should used! Altria 2011 MFMER | slide-12 Package of 16 discs, each tobacco control programs volume of aspirate. Is chewed or held in the form of loose leaf, plugs, or intravenous carbohydrate.... Not limited to, aspiration pneumonia, respiratory compromise, and no reliability tests for locating research were. Strongly agree that, when antacids are indicated for selected patients, only antacids... The chewing tobacco as nonsmokers centuries, ever since the indigenous people of America assist the practitioner and patient making... Heart disease and stroke affect gastric emptying or fluid volume npo guidelines 2020 chewing tobacco Anaesthesiol. Try looking up a doctor, a clinic location, or intravenous administration during after!, when antacids are indicated for selected patients, only nonparticulate antacids be... Cranberry juice comparison chewing tobacco npo guidelines cimetidine and sodium citrate on gastric fluid volumes diabetic.