I know that with elective surgeries, patients have to fast the night before to prevent vomiting when they go under anesthetic, but I was wondering how this concern is navigated in trauma or emergency surgeries in which patients definitely didn’t fast the night before? Do they just try to deal with the vomit or is there a special procedure to prevent vomiting from occurring?
In: 1727
ELI5: Missed tips and some myths and misconceptions in many good previous answers.
(1) For elective surgery in healthy patient without previous upper abdomen/digestive tract surgeries is recommended to fast after light meal for 6 hours, and for 2 hours after clear carbonated fluids.
But this will not prevent vomiting and will not 100% guarantee no stomach content 😕. The only reason to fast is hopefully to reduce stomach content volume and content acidity and to lower risk of clinically significant aspiration.
Vomiting is active ejection of stomach content because of contraction of abdomen, chest and diaphragm muscles. The only way to avoid vomiting is to fully paralyze the patient.
Even then paralyzed patient can regurgitate (stomach content returns to mouth). Suction tube should be handy.
And aspirate (mouth content enters lungs).
Tracheal tube cuff does not prevent aspiration (ask your ICU colleagues).
When there’s a patient out of category (1), recommendations for fasting are less relevant because they are approved for healthy patients and elective surgeries only.
When there’s a crashing patient, he most probably will have more chances to survive when damage control done in short time even in the case of aspiration during airway management.
And here’s some [fun technic of airway management during regurgitation](https://youtu.be/Jaq-vHbcGi0)
Latest Answers