If someone goes in for emergency surgery requiring general anesthesia, how do you prevent aspiration assuming they ate beforehand since it was unplanned?
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I’m an anesthesiologist. There are a couple of things we do differently to *reduce the risk* of aspiration. Aspiration is always a risk, even if you haven’t eaten in a day. The risk is just significantly higher if you have a full stomach.
We can do something called a rapid sequence induction, where we put you to sleep and paralyze you as fast as possible to minimize the time between starting anesthesia and securing the airway. We avoid mask ventilation because that can push air into the stomach and increase the risk of vomiting. We can apply pressure to the throat while you’re going to sleep to pinch off the esophagus (though the data for this is minimal and I don’t think it does anything). We can also possibly place a tube through your nose or mouth into your stomach while you’re awake to suction out whatever is inside.
All of these things are unnecessary and create a little more risk in someone who is appropriately NPO, but since they decrease the risk of aspiration they lower the overall risk for someone who is *not* NPO.
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