Before your procedure

If you will receive sedation, your stomach needs to be empty. Food in the stomach can come back up and enter the lungs while you are drowsy, which can cause a serious lung infection.

Some procedures, such as a PICC line or a thyroid biopsy, are done with local numbing only and may not require fasting. We will tell you when you are scheduled.

Bring a complete list of your medicines, doses and when you take them, including vitamins, supplements and over-the-counter pain relievers. A photo of your pill bottles works too.

GLP-1 medicines include semaglutide, tirzepatide, liraglutide and dulaglutide, used for diabetes or weight loss. Because they slow down how fast the stomach empties, some patients still have food in the stomach after a normal fast. Depending on your dose and symptoms, we may ask you to hold a weekly injection for one week, skip a daily dose on the day of the procedure, or follow a clear liquid diet for 24 hours beforehand.

SGLT2 medicines for diabetes or heart failure, such as empagliflozin, dapagliflozin and canagliflozin, are often paused for 3 days before a procedure with sedation (4 days for ertugliflozin). Metformin is usually skipped on the morning of the procedure and, after contrast, sometimes held for 48 hours if your kidneys are weak. We will check your blood sugar when you arrive and treat it if needed.

Many IR procedures use contrast, a dye that makes blood vessels visible on X-ray. Tell us if you have ever had hives, swelling, trouble breathing or another reaction to contrast.

If you have had a reaction before, we can often still do the procedure safely. We may give you steroid pills and an antihistamine starting the night before, or use a different type of imaging. An allergy to shellfish or iodine in food does not by itself mean you are allergic to contrast, but please tell us about it anyway.

Also tell us if you are allergic to latex, numbing medicines, sedatives, antibiotics or adhesive tape.

If you receive sedation, you must have a responsible adult take you home. Sedation can slow your reactions and judgment for the rest of the day, even if you feel normal. A taxi or rideshare on your own is not allowed. If you do not have a driver, your procedure may need to be rescheduled.

Plan not to drive, drink alcohol, sign legal papers or make big decisions for 24 hours. Ideally, someone should stay with you overnight. Learn more about sedation.

Plan to arrive 2 hours before your scheduled time. At El Camino Hospital, start at Patient Registration on the main floor; the front desk volunteers can walk you there. Registration staff will then send you to the pre-procedure area.

A nurse will review your health history and medicines, place a small IV in your hand or arm and may draw blood, including clotting tests if you do not have recent results. You will meet the doctor, who will explain the procedure and its risks and answer your questions before you sign the consent form.

We do our best to stay on schedule, but hospital emergencies sometimes cause delays. Most procedures take 30 to 90 minutes, and most patients spend 1 to 2 hours in recovery afterward. Procedures without sedation often allow you to leave right away.

Most delays and cancellations I see come from three things: a blood thinner that was not paused correctly, eating too close to the procedure, or no ride home. If you are unsure about any of these, call us the day before. I would much rather answer a quick question than reschedule you.

Fabio Komlos, MD, interventional radiologist · About Dr. Fabio Komlos