Status and appropriateness of fasting in the emergency department

¹Department of Nursing, Seoul Metropolitan Government Seoul National University Boramae Medical Center, Seoul, Korea
²Department of Emergency Medicine, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea

Correspondence

Stephen Gyung Won Lee ,Tel: 02-2228-2678, Fax: 02-2227-7908, Email: leestephengyungwon@gmail.com,

Received: January 23, 2025; Revised: September 13, 2025 Accepted: October 11, 2025. Published online: April 30, 2026.

ABSTRACT

Objective:
Prolonged fasting has been reported to have a negative effect on patient outcomes. Although fasting is routinely practiced in the emergency department (ED), there is limited evidence on the current status and appropriateness of fasting in the ED. This study examined the status and appropriateness of fasting in the ED and identified the characteristics of patients who experienced unnecessary fasting.
Methods:
A retrospective observational study was performed at an urban ED in Seoul, Korea. The fasting status and characteristics of adult patients who visited the ED and were admitted or discharged between April 1 and April 30, 2022, were analyzed. A checklist for discontinuing fasting in the ED was used to screen for unnecessary fasting.
Results:
Among 2,292 patients who met the study inclusion criteria, all patients were instructed to begin fasting upon ED arrival. Fasting was discontinued by the physician’s order in 300 patients (13.1%). Patients remained fasting for 92.0%±23.2% of their total ED length of stay. Of the 1,577 patients eligible for fasting discontinuation according to the checklist, 249 patients (15.8%) were ordered to discontinue fasting, and 1,328 patients (84.2%) experienced unnecessary fasting.
Conclusion:
ED patients spent significant time fasting during their ED length of stay. A high prevalence of unnecessary fasting was identified in the ED.

Key words: Emergency medical service; Fasting; Patient safety; Physicians’ practice patterns; Hospital emergency service